Contract Pharmacy Details

OPTUM FRONTIER THERAPIES II, LLC
DSH240080 UNIVERSITY OF MINNESOTA MEDICAL CENTER

Covered Entity Details

Entity Name

UNIVERSITY OF MINNESOTA MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH240080

Entity Address

500 HARVARD ST. SE
MINNEAPOLIS, MN 55455

Medicare Provider Number

240080

Participating Start Date

7/1/2006

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

OPTUM FRONTIER THERAPIES II, LLC

Pharmacy Address

6425 SANTA MARGARITA ST UNIT 110
LAS VEGAS, NV 89118-1913

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

Trudi Noel Trysla, Chief Legal Officer
(612) 672-6382

Contract Pharmacy Representative

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

Signed By Date

7/17/2023

340B Drug Pricing Program Database