340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM INFUSION SERVICES 500, INC.
HM29601 Prisma Health
Print
Covered Entity Details
Entity Name
Prisma Health
Subdivision Name
DBA Hemostasis and Thrombosis Center of South Carolina - Upstate
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM29601
Entity Address
900 West Faris Road
2nd floor
Greenville, SC 29605
Grant Number
H30MC24046
Participating Start Date
7/1/2021
Last Recertification Date
2/13/2025
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
4/20/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stephanie Ambrose, Medical Director - Hemophilia Treatment Center
(803) 434-3508
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/20/2022
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