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OPTUM PHARMACY 702, LLC
DSH390044 READING HOSPITAL
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Covered Entity Details
Entity Name
READING HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390044
Entity Address
420 South 5th Avenue
West Reading, PA 19611
Medicare Provider Number
390044
Participating Start Date
1/1/2017
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
5/12/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Ehinger, CFO
(484) 628-8445
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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