340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 701, LLC
RRC150082-00 DEACONESS HOSPITAL
Print
Covered Entity Details
Entity Name
DEACONESS HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC150082-00
Entity Address
600 MARY STREET
EVANSVILLE, IN 47747
Medicare Provider Number
150082
Participating Start Date
10/20/2021
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/8/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl Wathen, Chief Financial Officer
(812) 450-3296
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/8/2024
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