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OPTUM PHARMACY 701, LLC
CAH051326-00 PLUMAS DISTRICT HOSPITAL CAH
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Covered Entity Details
Entity Name
PLUMAS DISTRICT HOSPITAL CAH
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051326-00
Entity Address
1065 BUCKS LAKE RD.
QUINCY, CA 95971
Medicare Provider Number
051326
Participating Start Date
1/1/2017
Last Recertification Date
8/19/2024
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
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caleb Johnson, Chief Financial Officer
(530) 283-7952
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/14/2022
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