340B Drug Pricing Program Database
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OPTUM PHARMACY 706, INC.
CAH041324-00 CHI St. Vincent Morrilton
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Covered Entity Details
Entity Name
CHI St. Vincent Morrilton
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041324-00
Entity Address
4 HOSPITAL DRIVE
MORRILTON, AR 72110
Medicare Provider Number
041324
Participating Start Date
9/28/2010
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 706, INC.
Pharmacy Address
30-30 47TH AVENUE
SUITE 410
LONG ISLAND CITY, NY 11101
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/31/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bubba Arnold, President
(501) 977-2413
Contract Pharmacy Representative
Briova Rx
Joe Iovino, Manager
(412) 445-4495
Signed By Date
7/12/2019
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