340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
CAH421301-02 ABBEVILLE COUNTY MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
ABBEVILLE COUNTY MEMORIAL HOSPITAL
Subdivision Name
ABBEVILLE COUNTY MEMORIAL HOSPITAL Rural Health Clinic
Type
Critical Access Hospital
340B ID
CAH421301-02
Entity Address
901 WEST GREENWOOD ST
SUITE 1
ABBEVILLE, SC 29620-5678
Medicare Provider Number
421301
Outpatient Facility Provider Number
423451
Participating Start Date
1/1/2016
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
1/15/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Willis Grant, Interim Chief Financial Officer
(864) 366-3310
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/15/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session