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OPTUM PHARMACY 701, LLC
CHC02456-00 WINDROSE HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
WINDROSE HEALTH NETWORK, INC.
Subdivision Name
Windrose Health Network - Trafalgar
Type
HRSA-Funded Health Center
340B ID
CHC02456-00
Entity Address
14 Trafalgar Sq
Trafalgar, IN 46181-9515
Grant Number
H80CS02456
Participating Start Date
10/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
4/3/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott K Rollett, CEO
(317) 739-4895 Ext: 2401
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/3/2024
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