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OPTUM PHARMACY 705, LLC
DSH340141 Novant Health New Hanover Regional Medical Center
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Covered Entity Details
Entity Name
Novant Health New Hanover Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340141
Entity Address
2131 South 17th Street
Attn: Pharmacy
Wilmington, NC 28401
Medicare Provider Number
340141
Participating Start Date
10/1/2003
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
10/9/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie Whalin, VP of Clinical Support Services
(910) 667-7731
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/9/2020
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