340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
CAH181305-00 ARH OUR LADY OF THE WAY
Print
Covered Entity Details
Entity Name
ARH OUR LADY OF THE WAY
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181305-00
Entity Address
11203 MAIN STREET
MARTIN, KY 41649
Medicare Provider Number
181305
Participating Start Date
9/24/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
5/31/2023
Contract Begin Date
6/5/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maria Braman, Chief Medical Officer
(406) 465-8506
Contract Pharmacy Representative
Optum
Patti Schnieder, 340B ACE
(402) 802-5169
Signed By Date
5/31/2023
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