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OPTUM INFUSION SERVICES 203 INC
HM337011 JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC.
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Covered Entity Details
Entity Name
JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC.
Subdivision Name
Johns Hopkins All Children's Outpatient Care, Fort Myers
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM337011
Entity Address
4550 Colonial Blvd.
Fort Myers, FL 33966
Grant Number
H30MC24046
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 203 INC
Pharmacy Address
9984 PREMIER PKWY
MIRAMAR, FL 33025-3209
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristy Alicia Kim Schulhof, President
(317) 775-3507
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/16/2024
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