Contract Pharmacy Details

OPTUM INFUSION SERVICES 201, INC.
DSH510001 WEST VIRGINIA UNIVERSITY HOSPITALS, INC.

Covered Entity Details

Entity Name

WEST VIRGINIA UNIVERSITY HOSPITALS, INC.

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH510001

Entity Address

1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506

Medicare Provider Number

510001

Participating Start Date

7/1/2002

Last Recertification Date

8/15/2024

Pharmacy Details

Pharmacy Name

OPTUM INFUSION SERVICES 201, INC.

Pharmacy Address

5700 DOT COM CT STE 1030
OVIEDO, FL 32765-3400

Pharmacy Comments

Contract Details

Approval Date

7/15/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Justin Gibson, VP of Finance-North Region
(304) 598-4256

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

7/15/2022

340B Drug Pricing Program Database