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OPTUM INFUSION SERVICES 500, INC.
HM8395 The Ohio State University Hemostasis and Thrombosis Center at the James
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Covered Entity Details
Entity Name
The Ohio State University Hemostasis and Thrombosis Center at the James
Subdivision Name
HEMOPHILIA TREATMENT CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM8395
Entity Address
460 W. 10th Avenue
COLUMBUS, OH 43210
Grant Number
H30MC24047
Participating Start Date
1/1/2003
Last Recertification Date
2/13/2025
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
7/14/2021
Contract Begin Date
8/16/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Eric H. Kraut, Director
(614) 293-2887
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/14/2021
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