340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
DSH330119 LENOX HILL HOSPITAL
Print
Covered Entity Details
Entity Name
LENOX HILL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330119
Entity Address
100 EAST 77TH STREET
NEW YORK, NY 10075
Medicare Provider Number
330119
Participating Start Date
1/24/2022
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
1/24/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michele L Cusack, Executive Vice President
(516) 321-6058
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
1/13/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session