340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM FRONTIER THERAPIES II, LLC
DSH300012 ELLIOT HOSPITAL
Print
Covered Entity Details
Entity Name
ELLIOT HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH300012
Entity Address
1 ELLIOT WAY
MANCHESTER, NH 03103
Medicare Provider Number
300012
Participating Start Date
3/12/2021
Last Recertification Date
9/14/2022
Entity Termination Date
1/1/2023
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
1/9/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Michael Turilli, Vice President - Finance
(978) 430-1352
Contract Pharmacy Representative
Optum RX
Joseph Iovino, VP
(412) 445-4495
Signed By Date
1/9/2019
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