Contract Pharmacy Details

OPTUM PHARMACY 702, LLC
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS

Covered Entity Details

Entity Name

NEW YORK CITY HEALTH AND HOSPITALS

Subdivision Name

Cumberland Diagnostic and Treatment Center

Type

HRSA-Funded Health Center

340B ID

CHC29018-00

Entity Address

100 N Portland Ave
Brooklyn, NY 11205-2005

Grant Number

H80CS29018

Participating Start Date

4/1/2016

Last Recertification Date

3/5/2025

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

Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446

Contract Pharmacy Representative

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

Signed By Date

10/17/2022

340B Drug Pricing Program Database