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OPTUM PHARMACY 806, INC.
DSH180040 UofL Health -- Louisville
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Covered Entity Details
Entity Name
UofL Health -- Louisville
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180040
Entity Address
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202-1818
Medicare Provider Number
180040
Participating Start Date
12/6/2005
Last Recertification Date
8/31/2024
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
7/15/2020
Contract Begin Date
7/15/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Steve Amsler, Senior Vice President of Operations
(502) 562-4122
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/15/2020
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