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OPTUM PHARMACY 702, LLC
CH03406B PRIMARY HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
PRIMARY HEALTH NETWORK, INC.
Subdivision Name
SHARON MEDICAL GROUP
Type
HRSA-Funded Health Center
340B ID
CH03406B
Entity Address
63 Pitt St
Sharon, PA 16146
Grant Number
H80CS00663
Participating Start Date
7/1/2002
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennie Slabe, Chief Information Officer
(724) 342-3002 Ext: 1505
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/17/2022
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