340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
CAH191323-01 Hospital Service District 1A, Parish of Richland, State of Louisiana, DBA Richland Parish Hospital
Print
Covered Entity Details
Entity Name
Hospital Service District 1A, Parish of Richland, State of Louisiana, DBA Richland Parish Hospital
Subdivision Name
Delhi Rural Health Clinic
Type
Critical Access Hospital
340B ID
CAH191323-01
Entity Address
508 Broadway Street
Delhi, LA 71232
Medicare Provider Number
191323
Outpatient Facility Provider Number
193417
Participating Start Date
7/1/2014
Last Recertification Date
8/14/2024
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
5/3/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Carroll, CEO
(318) 878-6323
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
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