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OPTUM PHARMACY 705, LLC
CAH521349-00 RIVER FALLS AREA HOSPITAL
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Covered Entity Details
Entity Name
RIVER FALLS AREA HOSPITAL
Subdivision Name
Main Hospital
Type
Critical Access Hospital
340B ID
CAH521349-00
Entity Address
1629 E. DIVISION ST.
RIVER FALLS, WI 54022-1571
Medicare Provider Number
521349
Participating Start Date
8/17/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
4/10/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/10/2023
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