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OPTUM PHARMACY 701, LLC
SCH170023-00 St. Catherine Hospital - Garden City
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Covered Entity Details
Entity Name
St. Catherine Hospital - Garden City
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH170023-00
Entity Address
401 E Spruce St
GARDEN CITY, KS 67846
Medicare Provider Number
170023
Participating Start Date
9/15/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
8131 W BOSTIAN RD STE A350
WOODINVILLE, WA 98072-5029
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
AMANDA VAUGHAN, CFO
(620) 272-2554
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/9/2020
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