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OPTUM PHARMACY 705, LLC
CAH261330-00 STE. GENEVIEVE COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
STE. GENEVIEVE COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH261330-00
Entity Address
800 STE. GENEVIEVE DRIVE
STE. GENEVIEVE, MO 63670-0468
Medicare Provider Number
261330
Participating Start Date
8/9/2010
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
2/2/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/18/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Stephen Pautler, CEO
(573) 883-7787
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/14/2022
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