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OPTUMRX
CH014580 PENOBSCOT COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
PENOBSCOT COMMUNITY HEALTH CENTER, INC.
Subdivision Name
BREWER MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH014580
Entity Address
735 WILSON ST
BREWER, ME 04412
Grant Number
H80CS04291
Participating Start Date
1/1/2005
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
OPTUMRX
Pharmacy Address
OPTUMRX INC
6800 W 115TH ST STE 600
OVERLAND PARK, KS 66211-9838
Pharmacy Comments
Contract Details
Approval Date
10/4/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/15/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lorelle Dwyer, President & CEO
(207) 992-9200
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/4/2022
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