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OPTUM PHARMACY 701, LLC
DSH230020 Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital
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Covered Entity Details
Entity Name
Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230020
Entity Address
18101 OAKWOOD BOULEVARD
DEARBORN, MI 48124
Medicare Provider Number
230020
Participating Start Date
7/1/2006
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
4100 S SAGINAW ST STE D
FLINT, MI 48507
Pharmacy Comments
Contract Details
Approval Date
4/8/2022
Contract Begin Date
4/13/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lee Ann Odom, President, Shared Services
(947) 522-2653
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/8/2022
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