Contract Pharmacy Details

OPTUMRX
CH030850 LINCOLN COUNTY PRIMARY CARE CENTER, INC.

Covered Entity Details

Entity Name

LINCOLN COUNTY PRIMARY CARE CENTER, INC.

Subdivision Name

LINCOLN COUNTY PRIMARY CARE CENTER, INC.

Type

HRSA-Funded Health Center

340B ID

CH030850

Entity Address

7400 Lynn Ave
Hamlin, WV 25523-1138

Grant Number

H80CS00254

Participating Start Date

1/1/2004

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

OPTUMRX

Pharmacy Address

OPTUMRX INC
6800 W 115TH ST STE 600
OVERLAND PARK, KS 66211-9838

Pharmacy Comments

Contract Details

Approval Date

7/15/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lisa King Leach, CEO
(304) 824-5806 Ext: 1236

Contract Pharmacy Representative

Optum
Avani Patel, VP, 340B Operations
(763) 330-5555

Signed By Date

7/15/2024

340B Drug Pricing Program Database