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OPTUM PHARMACY 705, LLC
CAH231329-00 CARO COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
CARO COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231329-00
Entity Address
401 N HOOPER ST
CARO, MI 48723
Medicare Provider Number
231329
Participating Start Date
4/21/2021
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matt Rick, Chief Operating Officer
(989) 894-3838
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/13/2023
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