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OPTUM FRONTIER THERAPIES, LLC
DSH330013 ALBANY MEDICAL CENTER HOSPITAL
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Covered Entity Details
Entity Name
ALBANY MEDICAL CENTER HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330013
Entity Address
43 NEW SCOTLAND AVENUE
ALBANY, NY 12208
Medicare Provider Number
330013
Participating Start Date
4/1/2006
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OPTUM FRONTIER THERAPIES, LLC
Pharmacy Address
325 W ATHERTON RD
SUITE 1
FLINT, MI 48507-2601
Pharmacy Comments
Contract Details
Approval Date
4/16/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/9/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Frances Spreer Albert, Executive Vice President, COO and CFO
(518) 262-3579
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/16/2024
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