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OPTUM PHARMACY 702, LLC
CH042160 DAYSPRING HEALTH, INC.
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Covered Entity Details
Entity Name
DAYSPRING HEALTH, INC.
Subdivision Name
DAYSPRING HEALTH, INC.
Type
HRSA-Funded Health Center
340B ID
CH042160
Entity Address
107 S Main St
Jellico, TN 37762-2154
Grant Number
H80CS00716
Participating Start Date
10/1/1996
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lawrence Michael Rector, COO/CFO
(423) 784-8492 Ext: 221
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/13/2022
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