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OPTUM INFUSION SERVICES 550, LLC
HM19803 Nemours Children's Hospital, Delaware
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Covered Entity Details
Entity Name
Nemours Children's Hospital, Delaware
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM19803
Entity Address
1600 Rockland Rd
Wilmington, DE 19803
Grant Number
H30MC48960
Participating Start Date
10/1/2021
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
OPTUM INFUSION SERVICES 550, LLC
Pharmacy Address
7167 E. KEMPER RD.
CINCINNATI, OH 45249
Pharmacy Comments
Contract Details
Approval Date
4/10/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Forman, Vice President of Finance
(302) 256-6060
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/10/2025
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