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OPTUM PHARMACY 705, LLC
DSH340030 DUKE UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
DUKE UNIVERSITY HOSPITAL
Subdivision Name
Duke University Hospital Main
Type
Disproportionate Share Hospital
340B ID
DSH340030
Entity Address
2301 Erwin Road
DURHAM, NC 27710
Medicare Provider Number
340030
Participating Start Date
4/1/2002
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Andrew Owens, Executive Vice President and COO, DUHS, President DUH
(919) 681-6624
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/17/2023
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