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OPTUM INFUSION SERVICES 305, LLC
HM1595 Ann and Robert H. Lurie Children's Hospital of Chicago
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Covered Entity Details
Entity Name
Ann and Robert H. Lurie Children's Hospital of Chicago
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM1595
Entity Address
225 E Chicago Ave
CHICAGO, IL 60611
Grant Number
H30MC24052
Participating Start Date
7/1/2000
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 305, LLC
Pharmacy Address
15529 COLLEGE BLVD.
LENEXA, KS 66219-1351
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jenny Elhadary, VP Clinical Services
(312) 227-4161
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/17/2023
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