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OPTUM PHARMACY 700, LLC
RRC230141-00 MCLAREN FLINT
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Covered Entity Details
Entity Name
MCLAREN FLINT
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230141-00
Entity Address
401 S. BALLENGER
FLINT, MI 48532
Medicare Provider Number
230141
Participating Start Date
12/22/2020
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
5700 DOT COM CT, STE 1000
OVIEDO, FL 32765
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
11/4/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
FRED KORTE, CFO
(248) 338-5691
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/15/2021
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