340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 701, LLC
DSH450828 CHRISTUS SPOHN HOSPITAL ALICE
Print
Covered Entity Details
Entity Name
CHRISTUS SPOHN HOSPITAL ALICE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450828
Entity Address
2500 EAST MAIN ST.
ALICE, TX 78332
Medicare Provider Number
450828
Participating Start Date
9/16/2005
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/7/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Becky Rios, Interim CFO
(361) 881-3157
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Sr VP of Strategic Sales
(651) 983-0677
Signed By Date
10/7/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session