340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
DSH420065 BON SECOURS - ST. FRANCIS XAVIER HOSPITAL
Print
Covered Entity Details
Entity Name
BON SECOURS - ST. FRANCIS XAVIER HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH420065
Entity Address
2095 HENRY TECKLENBURG DRIVE
CHARLESTON, SC 29414
Medicare Provider Number
420065
Participating Start Date
10/1/2010
Last Recertification Date
9/4/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
7/19/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Christopher Lawrence Glenn, Director of Finance
(843) 789-1705
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/15/2022
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