340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
DSH010120 MONROE COUNTY HOSPITAL
Print
Covered Entity Details
Entity Name
MONROE COUNTY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010120
Entity Address
2016 S Alabama Ave
MONROEVILLE, AL 36460
Medicare Provider Number
010120
Participating Start Date
4/1/2006
Last Recertification Date
8/16/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
12/22/2020
Contract Begin Date
12/22/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Cynthia Martens, Director of Pharmacy
(251) 743-7434
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
12/22/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session