Contract Pharmacy Details

OPTUM FRONTIER THERAPIES, LLC
DSH210009 JOHNS HOPKINS HOSPITAL

Covered Entity Details

Entity Name

JOHNS HOPKINS HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH210009

Entity Address

600 NORTH WOLFE STREET
BALTIMORE, MD 21287

Medicare Provider Number

210009

Participating Start Date

7/1/2002

Last Recertification Date

9/4/2024

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

7/14/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Katina Williams, VP CFO
(410) 502-5388

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

7/14/2023

340B Drug Pricing Program Database