340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM FRONTIER THERAPIES II, LLC
DSH260005AD SSM ST. JOSEPH HEALTH CENTER
Print
Covered Entity Details
Entity Name
SSM ST. JOSEPH HEALTH CENTER
Subdivision Name
SSMHI at SCCMG - Wall Street Ste 330 / Heart Institute
Type
Disproportionate Share Hospital
340B ID
DSH260005AD
Entity Address
1551 Wall Street
Suite 330
St. Charles, MO 63303
Medicare Provider Number
260005
Outpatient Facility Provider Number
260005
Participating Start Date
10/1/2015
Last Recertification Date
8/22/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES II, LLC
Pharmacy Address
6425 SANTA MARGARITA ST UNIT 110
LAS VEGAS, NV 89118-1913
Pharmacy Comments
Contract Details
Approval Date
7/10/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/31/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
Karen D. Rewerts, Regional VP of Financa/CFO
(314) 989-2034
Contract Pharmacy Representative
Briova Rx
Joe Iovino, Manager
(412) 445-4495
Signed By Date
7/10/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session