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OPTUM INFUSION SERVICES 308, LLC
DSH510062 APPALACHIAN REGIONAL HEALTHCARE, INC.
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE, INC.
Subdivision Name
DBA BECKLEY ARH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH510062
Entity Address
306 STANAFORD ROAD
BECKLEY, WV 25801
Medicare Provider Number
510062
Participating Start Date
4/1/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 308, LLC
Pharmacy Address
6547 S RACINE CIR STE 300
CENTENNIAL, CO 80111
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maria Braman, Chief Medical Officer
(406) 465-8506
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/16/2023
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