Contract Pharmacy Details

OPTUMRX
DSH230046 UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS

Covered Entity Details

Entity Name

UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230046

Entity Address

1500 EAST MEDICAL CENTER DRIVE
ANN ARBOR, MI 48109

Medicare Provider Number

230046

Participating Start Date

1/1/2004

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

OPTUMRX

Pharmacy Address

OPTUMRX INC
6800 W 115TH ST STE 600
OVERLAND PARK, KS 66211-9838

Pharmacy Comments

Contract Details

Approval Date

4/15/2020

Contract Begin Date

4/29/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jeffrey S. Desmond, Chief Medical Officer
(734) 936-5814

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

4/15/2020

340B Drug Pricing Program Database