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OPTUM INFUSION SERVICES 500, INC.
DSH050396 SANTA BARBARA COTTAGE HOSPITAL
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Covered Entity Details
Entity Name
SANTA BARBARA COTTAGE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050396
Entity Address
400 WEST PUEBLO STREET
SANTA BARBARA, CA 93105
Medicare Provider Number
050396
Participating Start Date
4/1/2017
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 500, INC.
Pharmacy Address
4900 RIVERGRADE RD STE E120
IRWINDALE, CA 91706-1419
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/12/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brett Tande, Senior Vice President of Finance
(805) 569-7294
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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