340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
DSH270032 NORTHERN MONTANA HOSPITAL
Print
Covered Entity Details
Entity Name
NORTHERN MONTANA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH270032
Entity Address
30-13TH STREET
HAVRE, MT 59501
Medicare Provider Number
270032
Participating Start Date
10/1/2009
Last Recertification Date
9/5/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
7/7/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/6/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Christen Obresley, VP, Regulatory Community Services
(406) 262-1420
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/7/2023
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