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OPTUM INFUSION SERVICES 201, INC.
DSH100012 LEE HEALTH SYSTEM, INC. DBA LEE HEALTH
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Covered Entity Details
Entity Name
LEE HEALTH SYSTEM, INC. DBA LEE HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100012
Entity Address
2776 CLEVELAND AVENUE
FORT MYERS, FL 33901
Medicare Provider Number
100012
Participating Start Date
1/1/2009
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 201, INC.
Pharmacy Address
5700 DOT COM CT STE 1030
OVIEDO, FL 32765-3400
Pharmacy Comments
Contract Details
Approval Date
7/16/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/20/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Benjamin Spence, CFO
(239) 343-6014
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/16/2021
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