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OPTUM FRONTIER THERAPIES, LLC
DSH070022 YALE NEW HAVEN HOSPITAL
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Covered Entity Details
Entity Name
YALE NEW HAVEN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070022
Entity Address
20 York Street
New Haven, CT 06510
Medicare Provider Number
070022
Participating Start Date
7/1/2004
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES, LLC
Pharmacy Address
325 W ATHERTON RD
SUITE 1
FLINT, MI 48507-2601
Pharmacy Comments
Contract Details
Approval Date
4/21/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Sr VP of Strategic Sales
(651) 983-0677
Signed By Date
4/21/2023
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