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OPTUM PHARMACY 800, INC.
CH06796D PROJECT VIDA HEALTH CENTER
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Covered Entity Details
Entity Name
PROJECT VIDA HEALTH CENTER
Subdivision Name
Montana Vista Health Center
Type
HRSA-Funded Health Center
340B ID
CH06796D
Entity Address
14674 Greg Dr.
El Paso, TX 79938-9241
Grant Number
H80CS04287
Participating Start Date
10/1/2009
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 800, INC.
Pharmacy Address
3016 GUADALUPE ST STE A
AUSTIN, TX 78705-2861
Pharmacy Comments
Contract Details
Approval Date
10/3/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bill Schlesinger, CEO
(915) 465-1191 Ext: 207
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
10/3/2017
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