340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 705, LLC
DSH390142 ALBERT EINSTEIN MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ALBERT EINSTEIN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390142
Entity Address
5501 OLD YORK ROAD
PHILADELPHIA, PA 19141
Medicare Provider Number
390142
Participating Start Date
1/1/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 705, LLC
Pharmacy Address
1100 LEE BRANCH LN
BIRMINGHAM, AL 35242-7298
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Walter Wyatt, VP-Finance
(215) 254-3254
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/12/2023
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