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OPTUM PHARMACY 701, LLC
DSH270004 BILLINGS CLINIC
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Covered Entity Details
Entity Name
BILLINGS CLINIC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH270004
Entity Address
2800 TENTH AVENUE NORTH
BILLINGS, MT 59101
Medicare Provider Number
270004
Participating Start Date
1/1/2016
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
8131 W BOSTIAN RD STE A350
WOODINVILLE, WA 98072-5029
Pharmacy Comments
Contract Details
Approval Date
7/7/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chad W Miller, Vice President Clinic Operations
(406) 657-4603
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Sr VP of Strategic Sales
(651) 983-0677
Signed By Date
7/7/2021
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