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OPTUM INFUSION SERVICES 500, INC.
HM18103 Lehigh Valley Hospital
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Covered Entity Details
Entity Name
Lehigh Valley Hospital
Subdivision Name
Hemophilia Treatment Program (CC)
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM18103
Entity Address
1240 South Cedar Crest Boulevard, Suite 310
Allentown, PA 18103
Grant Number
5H30MC48960-03-00
Participating Start Date
4/1/2021
Last Recertification Date
2/11/2025
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
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/6/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943
Contract Pharmacy Representative
Optum
Nancy Mccutcheon, SR. VP of Strategic Sales
(651) 983-0677
Signed By Date
4/14/2022
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