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OPTUM INFUSION SERVICES 500 INC
DSH440039 Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
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Covered Entity Details
Entity Name
Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440039
Entity Address
1211 MEDICAL CENTER DRIVE
NASHVILLE, TN 37232
Medicare Provider Number
440039
Participating Start Date
7/1/2002
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 500 INC
Pharmacy Address
1893 GENERAL GEORGE PATTON DR
# 100
FRANKLIN, TN 37067-2655
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Edgar Newman, Vice President
(615) 293-3406
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/15/2024
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