340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
DSH450046 CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE
Print
Covered Entity Details
Entity Name
CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450046
Entity Address
600 Elizabeth St.
CORPUS CHRISTI, TX 78404
Medicare Provider Number
450046
Participating Start Date
4/1/1997
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
6/10/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Becky Rios, Interim CFO
(361) 881-3157
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Sr VP of Strategic Sales
(651) 983-0677
Signed By Date
4/13/2020
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