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OPTUM INFUSION SERVICES 501, INC.
CH070300 NORTHEAST MISSOURI HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Subdivision Name
Northeast Missouri Health Council, Inc.
Type
HRSA-Funded Health Center
340B ID
CH070300
Entity Address
1416 Crown Drive
Kirksville, MO 63501
Grant Number
H80CS00731
Participating Start Date
7/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 501, INC.
Pharmacy Address
1867 LACKLAND HILL PKWY
SAINT LOUIS, MO 63146
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANDREW GRIMM, EXECUTIVE DIRECTOR
(660) 627-5757
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/11/2024
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