340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM INFUSION SERVICES 500, INC.
PED393303-00 THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Print
Covered Entity Details
Entity Name
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Subdivision Name
Type
Children's Hospital
340B ID
PED393303-00
Entity Address
3401 Civic Center Blvd
PHILADELPHIA, PA 19104
Medicare Provider Number
393303
Participating Start Date
1/1/2010
Last Recertification Date
8/28/2024
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
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Thomas Dole, SVP and COO Main Hospital, Philadelphia Campus
(267) 426-2452
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/14/2022
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