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OPTUM PHARMACY 701, LLC
DSH050396 SANTA BARBARA COTTAGE HOSPITAL
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Covered Entity Details
Entity Name
SANTA BARBARA COTTAGE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050396
Entity Address
400 WEST PUEBLO STREET
SANTA BARBARA, CA 93105
Medicare Provider Number
050396
Participating Start Date
4/1/2017
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/15/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristin Tufvesson, Sr. Vice President Finance & CFO
(805) 879-8941
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/15/2023
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