340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
SCH490021-00 CENTRA HEALTH
Print
Covered Entity Details
Entity Name
CENTRA HEALTH
Subdivision Name
Lynchburg General Hospital
Type
Sole Community Hospital
340B ID
SCH490021-00
Entity Address
1920 ATHERHOLT ROAD
LYNCHBURG, VA 24501
Medicare Provider Number
490021
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tabitha M. Culbertson, President, Lynchburg General &Virginia Baptist Hospitals
(434) 200-3014
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/14/2022
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