Contract Pharmacy Details

OPTUM FRONTIER THERAPIES II, LLC
RWII34982D Midway Specialty Care Center Inc

Covered Entity Details

Entity Name

Midway Specialty Care Center Inc

Subdivision Name

Type

Ryan White Part B

340B ID

RWII34982D

Entity Address

1434 Kennedy Drive
Key West, FL 33040

Grant Number

X07HA00057

Participating Start Date

4/1/2020

Last Recertification Date

2/20/2023

Entity Termination Date

4/1/2024

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

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Kathryn E Hayden, CFO
(772) 742-9276

Contract Pharmacy Representative

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

Signed By Date

7/15/2020

340B Drug Pricing Program Database