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OPTUMRX
CH010810 South-West Community Health Center, Inc.
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Covered Entity Details
Entity Name
South-West Community Health Center, Inc.
Subdivision Name
SOUTHWEST COMMUNITY HLTH CTR, INC
Type
HRSA-Funded Health Center
340B ID
CH010810
Entity Address
46 Albion St
Bridgeport, CT 06605-2602
Grant Number
H80CS00613
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
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
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mollie Melbourne, President/CEO
(203) 332-3501
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/14/2024
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