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OPTUM PHARMACY 701, LLC
CH062360 BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
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Covered Entity Details
Entity Name
BARRIO COMPREHENSIVE FAMILY HEALTH CARE CENTER, INC.
Subdivision Name
CommuniCare Health Centers - West
Type
HRSA-Funded Health Center
340B ID
CH062360
Entity Address
1102 Barclay St
San Antonio, TX 78207
Grant Number
H80CS00672
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Nguyen, President & CEO
(210) 233-7070 Ext: 7886
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/15/2024
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