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OPTUM PHARMACY 705, LLC
SCH270017-00 SAINT JAMES HEALTHCARE
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Covered Entity Details
Entity Name
SAINT JAMES HEALTHCARE
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH270017-00
Entity Address
400 SOUTH CLARK
BUTTE, MT 59701
Medicare Provider Number
270017
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
4/18/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Pam Palagi, VP of Finacial Services
(406) 723-2414
Contract Pharmacy Representative
Optum
McKinnlee Bowman, National Account Manager
(855) 828-9834
Signed By Date
4/18/2022
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