340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OPTUM PHARMACY 702, LLC
DSH390329 EINSTEIN MEDICAL CENTER MONTGOMERY
Print
Covered Entity Details
Entity Name
EINSTEIN MEDICAL CENTER MONTGOMERY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390329
Entity Address
559 WEST GERMANTOWN PIKE
EAST NORRITON, PA 19403
Medicare Provider Number
390329
Participating Start Date
7/1/2016
Last Recertification Date
8/20/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
7/5/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Beth Duffy, Chief Operating Officer
(484) 622-7004
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
7/5/2017
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