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OPTUM PHARMACY 700, LLC
RRC230227-00 MCLAREN MACOMB
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Covered Entity Details
Entity Name
MCLAREN MACOMB
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230227-00
Entity Address
1000 HARRINGTON
MT. CLEMENS, MI 48043
Medicare Provider Number
230227
Participating Start Date
12/1/2020
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 700, LLC
Pharmacy Address
5700 DOT COM CT, STE 1000
OVIEDO, FL 32765
Pharmacy Comments
Contract Details
Approval Date
4/2/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Snyder, Chief Financial Officer
(586) 493-3044
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/2/2024
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