340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 806, INC.
SCH380001-00 Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge
Print
Covered Entity Details
Entity Name
Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH380001-00
Entity Address
1700 E 19TH STREET
THE DALLES, OR 97058-3398
Medicare Provider Number
380001
Participating Start Date
9/28/2010
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 806, INC.
Pharmacy Address
2288 AUBURN BLVD
STE. 102
SACRAMENTO, CA 95821-1618
Pharmacy Comments
Contract Details
Approval Date
10/1/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/8/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
DENNIS KNOX, CEO
(541) 296-7272
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/1/2019
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