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OPTUM FRONTIER THERAPIES II, LLC
DSH050030 OROVILLE HOSPITAL
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Covered Entity Details
Entity Name
OROVILLE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050030
Entity Address
2767 OLIVE HIGHWAY
OROVILLE, CA 95966
Medicare Provider Number
050030
Participating Start Date
7/1/2006
Last Recertification Date
8/16/2024
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
10/3/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ASHOK P. KHANCHANDANI, EXECUTIVE VICE PRESIDENT/CFO
(530) 532-8509
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/3/2019
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