340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 701, LLC
DSH330125 ROCHESTER GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
ROCHESTER GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330125
Entity Address
1425 PORTLAND AVENUE
ROCHESTER, NY 14621
Medicare Provider Number
330125
Participating Start Date
10/1/2019
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
1830 S HORNE
MESA, AZ 85204
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shawn Bishop, Vice President, RRH Revenue & Reimbursement
(585) 922-0056
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
10/15/2024
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