340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM INFUSION SERVICES 204, INC
DSH230046 UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
Print
Covered Entity Details
Entity Name
UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230046
Entity Address
1500 EAST MEDICAL CENTER DRIVE
ANN ARBOR, MI 48109
Medicare Provider Number
230046
Participating Start Date
1/1/2004
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 204, INC
Pharmacy Address
4220 EXECUTIVE CIRCLE, SUITE 62
FORT MYERS, FL 33916
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
4/19/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeffrey S. Desmond, Chief Medical Officer
(734) 936-5814
Contract Pharmacy Representative
Avella/BriovaRx
Paul Leschinert, National Account Manager,340B Sales
(847) 409-0200
Signed By Date
4/15/2021
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