Upload
doanliem
View
219
Download
0
Embed Size (px)
Citation preview
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Alabama
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Alabama
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Alabama
BCBS OF ALABAMA AND BCBS OF TENNESSEE
Blue Cross and Blue Shield of Alabama PDP
Clinical Pharmacy Admin Barry Lesley
1-334-213-6653
450 Riverchase Parkway East Birmingham AL 35244
Alabama
BLUE CROSS AND BLUE SHIELD OF ALABAMA
Blue Cross Blue Shield of Alabama Local CCP
Clinical Pharmacy Admin Barry Lesley
1-334-213-6653
4465 Park Boulevard Montgomery AL
36116-1626
Alabama
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Alabama
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Alabama
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Alabama
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
AlabamaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Alabama
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Alabama
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Alabama
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
AlabamaHEALTHSPRING OF ALABAMA, INC.
Healthspring of Alabama, Inc. Local CCP
Director, Government Programs Christopher Kelly
1-615-565-8110
601 Mainstream Drive Nashville TN 37228
Alabama
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Alabama
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Alabama
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Alabama
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MTMP Contacts, Updated 11/15/07 1
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
AlabamaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Alabama
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Alabama
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Alabama
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Alabama RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Alabama
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Alabama
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Alabama
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Alabama
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Alabama
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Alabama
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Alabama
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Alabama
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Alabama
UNITED HEALTHCARE OF ALABAMA, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego Jr., MD Joseph E
1-949-221-9994
1-949-747-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Alabama VIVA HEALTH, INC. VIVA Medicare Plus Local CCP
Manager of Quality Improvement Scott Jan P
1-205-930-5520
1-205-930-5597
1222 14th Avenue South Birmingham AL 35205
Alabama
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Alabama
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
AlabamaWINDSOR HEALTH PLAN, INC Windsor Rx PDP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
MTMP Contacts, Updated 11/15/07 2
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Alaska
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Alaska
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Alaska
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Alaska
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
AlaskaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Alaska
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Alaska
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Alaska
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Alaska
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Alaska
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Alaska
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Alaska
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
AlaskaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Alaska
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Alaska
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Alaska RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Alaska
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
MTMP Contacts, Updated 11/15/07 3
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Alaska
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Alaska
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Alaska
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Alaska
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Alaska
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Alaska
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Alaska
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Alaska
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
American Samoa
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Arizona
ABRAZO ADVANTAGE HEALTH PLAN
Abrazo Advantage Health Plan Local CCP
Pharmacy Director Cruz Patti
1-602-824-3773
1-602-824-3762
[email protected] 7878 N. 16th St. Suite 105 Phoenix AZ 85020
Arizona AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Arizona
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Arizona
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Arizona
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
ArizonaARCADIAN HEALTH PLAN, INC.
Desert Canyon Community Care Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
Arizona
ARIZONA PHYSICIANS IPA, INC.
APIPA Personal Care Plus Local CCP
Director, Pharmacy Management Hatch Vanessa
1-703-226-3126
8045 Leesburg Pike Suite 600 Vienna VA 22182
MTMP Contacts, Updated 11/15/07 4
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
ArizonaCARE1ST HEALTH PLAN OF ARIZONA
ONECare by Care1st Health Plan Of Arizona Local CCP
Director of Pharmacy Griffith Jacque
1-602-778-1850 1819
2355 E. Camelback Rd., Ste. 300 Phoenix AZ 85016
Arizona
CIGNA HEALTHCARE OF ARIZONA, INC.
CIGNA HealthCare for Seniors Local CCP Chief Pharmacist Zheng Yi
1-860-226-6731
900 Cottage Grove Rd. Wilde Hartford CT 06152
Arizona
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Arizona
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Arizona
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Arizona
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
ArizonaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Arizona
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
ArizonaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
ArizonaHEALTH CHOICE ARIZONA, INC.
Health Choice Generations Local CCP
Director, Pharmacy Sartor Lynn
1-480-303-4431
1-480-350-2231
1600 W. Broadway, Suite 110 Tempe AZ 85282
Arizona
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Arizona
HEALTH NET LIFE INSURANCE COMPANY Health Net Regional CCP
Senior Vice President, Chief Clinical Officer White Virginia E
1-916-463-9603
10540 White Rock Rd., Ste 280
Mail Stop: CA-175-02-02
Rancho Cordove CA 95670
ArizonaHEALTH NET OF ARIZONA, INC.
Health Net of Arizona, Inc. Local CCP
Senior Vice President
White, Pharm. D. Virginia E
1-916-463-9603
1-916-463-9750
10540 White Rock Rd., Ste. 280
Rancho Cordova CA 95670
Arizona
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
ArizonaHUMANA HEALTH PLAN, INC.
Humana Health Plan, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arizona
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arizona
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arizona
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arizona
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MTMP Contacts, Updated 11/15/07 5
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Arizona
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
ArizonaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Arizona
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Arizona
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
ArizonaPACIFICARE OF ARIZONA, INC
Secure Horizons Medicare Advantage Plan Local CCP
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Arizona
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Arizona
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Arizona RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
ArizonaSCAN HEALTH PLAN OF ARIZONA
SCAN Health Plan Arizona Local CCP
Director of Pharmacy Bakshi Sharon
1-562-989-5168
1-562-997-3196
3800 Kilroy Airport Way Suite 100 Long Beach CA 90806
Arizona
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. Sierra Spectrum Local CCP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Arizona
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Arizona
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Arizona
SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION
Mercy Care Advantage Local CCP
Corporate Director of Pharmacy Clark Mark
1-602-659-1100
4645 E Cotton Center Blvd
Building 1, Suite 200 Phoenix AZ 85040
Arizona
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Arizona
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
ArizonaSUN HEALTH MEDISUN, INC.
Sun Health MediSunONE Local CCP
Director of Pharmacy Nesemann Lydia
1-623-974-7474
1-623-974-7495
[email protected] P.O. Box 1489
13632 N. 99th Ave, Suite B Sun City AZ 85372
Arizona
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Arizona
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
MTMP Contacts, Updated 11/15/07 6
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Arizona
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Arizona
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Arizona
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Arizona
UNITED HEALTHCARE INSURANCE COMPANY
UNITED HEALTHCARE INSURANCE COMPANY Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Arizona
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
ArizonaUNITEDHEALTHCARE OF ARIZONA INC SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Arizona
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
Arizona
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Arizona
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Arkansas
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Arkansas
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
ArkansasARKANSAS BCBS, A MUTUAL INS CO
Arkansas Blue Cross and Blue Shield PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Arkansas
ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.
Arkansas Blue Cross - Medi-Pak Advantage PFFS
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
ArkansasARKANSAS COMMUNITY CARE
Arkansas Community Care, Inc. Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
Arkansas
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
Care Improvement Plus Regional CCP Moyna Audrey
1-847-555-9399
1-847-559-4733
2211 Sanders Road Suite 100 Northbrook IL 60062
MTMP Contacts, Updated 11/15/07 7
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Arkansas
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Arkansas
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Arkansas
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Arkansas
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
ArkansasEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Arkansas
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
ArkansasFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Arkansas
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Arkansas
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Arkansas
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arkansas
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arkansas
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Arkansas
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
ArkansasMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Arkansas
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Arkansas
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Arkansas
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Arkansas
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
MTMP Contacts, Updated 11/15/07 8
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Arkansas RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Arkansas
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Arkansas
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Arkansas
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Arkansas
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Arkansas
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Arkansas
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Arkansas
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Arkansas
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Arkansas
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Arkansas
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Arkansas
UNITEDHEALTHCARE OF ARKANSAS, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Arkansas
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Arkansas
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
ArkansasWINDSOR HEALTH PLAN, INC Windsor Rx PDP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
ArkansasWINDSOR HEALTH PLANS, INC.
Windsor Medicare Extra Local CCP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
CaliforniaAETNA HEALTH OF CALIFORNIA,INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 9
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
California
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
California
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
CaliforniaAIDS HEALTHCARE FOUNDATION
POSITIVE HEALTHCARE PARTNERS Local CCP
REGIONAL MGR. OF UM & CASE MGMT. KIRKORIAN CYNTHIA
1-323-436-5016
1-323-436-5034
1001 N. MARTEL AVE. LOS ANGELES CA 90046
California
ANTHEM INSURANCE COMPANIES, INC.
Blue Cross of California PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
CaliforniaARTA MEDICARE HEALTH PLAN, INC.
Arta Medicare Health Plan Local CCP
Pharmacy Director Sefain Hani
1-818-368-7538
1-818-368-7169
19641 Tulsa Street Chatsworth CA 91311
California
BC LIFE and HEALTH INSURANCE COMPANY
BC LIFE & HEALTH INSURANCE COMPANY Regional CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
CaliforniaBLUE CROSS OF CALIFORNIA
Blue Cross of California Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
CaliforniaBLUE CROSS OF CALIFORNIA
Blue Cross Of California PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
California
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
California
CA PHYSICIANS' SERVICE DBA BLUE SHIELD OF CA
Blue Shield of California PDP
Medication Management Coordinator Becker-Ellison Dawn
1-916-350-6624
1-916-350-6216
4205 Town Center Blvd
El Dorado Hills El Dorado Hills CA 95762
California
CALIFORNIA PHYSICIANS' SERVICE
Blue Shield of California Local CCP
Medication Management Coordinator Becker-Ellison Dawn
1-916-350-6624
1-916-350-6216
4205 Town Center Blvd El Dorado Hills CA 95762
CaliforniaCARE1ST HEALTH PLAN
Care1st Medicare Advantage Plan Local CCP
Pharmacy Director Lasconia Michael
1-323-889-6638 6260
601 Potrero Grande Drive Monterey Park CA 91755
CaliforniaCAREMORE HEALTH PLAN
CareMore Health Plan Local CCP
Director of Pharmacy Rose James
1-562-622-2982
1-562-622-2814
12900 Park Plaza Drive Suite 150 Cerritos CA 90703
California
CENTRAL HEALTH PLAN OF CALIFORNIA, INC.
Central Health Medicare Plan Local CCP
Pharmacy Operations Manager Britton, MD Timothy
1-866-314-2427 2229
1-626-388-2363
1051 Park View Drive Suite 120 Covina CA 91724
California
CHINESE COMMUNITY HEALTH PLAN
Chinese Community Health Plan Local CCP Hill Jerry
1-415-955-8800 3235
1-415-955-8814
445 Grant Avenue, Suite 700 San Francisco CA 94108
CaliforniaCITIZENS CHOICE HEALTHPLAN
Citizens Choice Healthplan Local CCP
Director, Health Care Services Maxon, RN Marcie
1-323-728-7232 2108
1-323-728-8494
5400 E. Olympic Blvd. Suite 130 Los Angeles CA 90022
California
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
California
CONTRA COSTA CO MED SVCS DBA CONTRA COSTA HEALTH
Contra Costa Health Plan Local CCP Lawson Mark
1-215-937-5352
1-215-937-8450
200 Stevens Drive Philadelpha PA 19113
MTMP Contacts, Updated 11/15/07 10
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
California
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
CaliforniaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
California
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
California
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
CaliforniaGEMCARE HEALTH PLAN INC.
GEMCARE Health Plan Local CCP
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] P.O. Box 407 Boys Town NE 68010
California
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
California
HEALTH NET LIFE INSURANCE COMPANY
Health Net Life Insurance Company Local CCP
Senior Vice President, Chief Clinical Officer
White, Pharm. D. Virginia E
1-916-463-9603
10540 White Rock Rd., Ste. 280
Mail Stop: CA-175-02-02
Rancho cordova CA 95670
California HEALTH NET_OF CA Health Net Of CA Local CCP V.P. OperationsWhite, Pharm. D. Virginia E
1-916-463-9603
1-916-463-9750
10540 White Rock Rd., Ste 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
California
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
California HMO CALIFORNIA HMO California Local CCP
Vice President Medicare Operations & Compliance Snyder Connie
1-562-981-5054
1-562-981-5818
1600 East Hill Street Signal Hill CA 90755
California
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
California
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
CaliforniaIEHP HEALTH ACCESS
IEHP Medicare DualChoice Local CCP
Director of Pharmaceutical Services Chan Chris
1-909-890-2943
1-909-890-2995
303 E. Vanderbilt Way, Suite 100 San Bernardino CA 92408
CaliforniaINTER VALLEY HEALTH PLAN, INC.
Inter Valley Health Plan Local CCP
VP of Health Services Tenorio Susan
1-800-251-8191 631
1-909-620-8092
[email protected] PO Box 6002
300 South Park Ave, Suite 300 Pomona CA
91769-6002
California
KAISER FOUNDATION HP, INC. Kaiser Permanente Local CCP
Director, Medicare Compliance Hall Jason
1-626-405-5333
393 E. Walnut Street, 5th Floor Pasadena CA 91188
California
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
California MEDCORE HP Medcore HP Local CCPClinical Program Manager Robertson Teisha A
1-301-218-6202
1-301-576-4442
13341 Burleigh Street Upper Marlboro MD 20774
CaliforniaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
California
MOLINA HEALTHCARE OF CALIFORNIA
Molina Healthcare of California Local CCP
Director, Pharmacy Schatzman Benjamin
1-562-951-1509
1-562-437-9315
One Golden Shore Drive Long Beach CA 90802
MTMP Contacts, Updated 11/15/07 11
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
California
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
California
ORANGE COUNTY HEALTH AUTHORITY OneCare Local CCP
Director of Clinical Pharmacy Gericke Kristin
1-714-246-8471
1-714-246-8649
1120 West La Veta Avenue Orange CA 92868
California
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
California
PACIFICARE OF CALIFORNIA/SECURE HORIZONS
Secure Horizons Medicare Advantage Plan Local CCP
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
California
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
California
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
California RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
California
SAN MATEO HEALTH COMMISSION
Health Plan of San Mateo Local CCP
Pharmacy Manager Cheung Barrie
1-650-616-2073
701 Gateway Blvd, Ste 400
South San Francisco CA 94080
California
SANTA CLARA COUNTY HEALTH AUTHORITY Healthy Generations Local CCP Garg Angeli
1-408-874-1818
1-408-874-1961
210 East Hacienda Ave Campbell CA 95008
California SCAN HEALTH PLAN SCAN Health Plan Local CCPDirector of Pharmacy Bakshi Sharon
1-562-989-5168
1-562-997-3196
3800 Kilroy Airport Way Suite 100 Long Beach CA 90806
California SCAN HEALTH PLAN SCAN Health Plan DemoDirector of Pharmacy Bakshi Sharon
1-562-989-5168
1-562-997-3196
3800 Kilroy Airport Way Suite 100 Long Beach CA 90806
California SCAN HEALTH PLAN VillageHealth DemoDirector of Pharmacy Bakshi Sharon
1-562-989-5168
1-562-997-3196
3800 Kilroy Airport Way Suite 100 Long Beach CA 90806
California
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
California
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
California
SOLANO-NAPA-YOLO COMMISSION ON MEDICAL CARE
Partnership HealthPlan of California Local CCP Medical Director Cammisa Chris
1-707-863-4228
1-707-863-4118
360 Campus Lane, Suite 100 Fairfield CA 94534
California
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
California
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
California
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
California
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 12
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
California
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
California
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
CaliforniaWESTERN HEALTH ADVANTAGE
Western Health Advantage Local CCP
Clinical Pharmacist Fischer Joe
1-916-563-2273
1-916-563-3182
2349 Gateway Oaks Drive, Suite 100 Sacramento CA 95833
Colorado
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Colorado
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
ColoradoANTHEM BC/BS OF COLORADO
Anthem Blue Cross & Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Ave
Mail Stop CAAF West Hills CA 91304
Colorado
ANTHEM INSURANCE COMPANIES, INC.
Anthem Insurance Companies, Inc. PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Colorado
ANTHEM INSURANCE COMPANIES, INC.
Blue Cross Blue Shield of Colorado PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
ColoradoCOLORADO ACCESS Colorado Access Local CCP
Director of Pharmacy Services McDow Chuck
1-720-744-5526
1-720-744-5127
10065 E. Harvard Ave Ste 600 Denver CO 80231
Colorado
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Colorado
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Colorado
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
ColoradoDENVER HEALTH MEDICAL PLAN, INC.
Denver Health Medical Plan Local CCP Medical Director Brody, MD David
1-720-956-2361
1-720-956-2303
777 Bannock Street
Mail Code 6000 Denver CO 80204
Colorado
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
ColoradoEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Colorado
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Colorado
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
MTMP Contacts, Updated 11/15/07 13
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Colorado
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Colorado
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Colorado
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Colorado
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Colorado
KAISER FOUNDATION HP OF CO Kaiser Permanente Local CCP
Quality & Clinical Pharmacy Manager Chester Beth
1-303-326-7612
1-303-739-3574
16601 E. Centretech Parkway Aurora CO 80011
Colorado
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
ColoradoMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Colorado
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Colorado
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
ColoradoPACIFICARE OF COLORADO, INC
Secure Horizons Medicare Advantage Plan Local CCP
VP, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Colorado
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Colorado
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Colorado
ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION
Rocky Mountain Health Plans PDP
Director, Pharmacy Department Nolan Steve
1-970-244-7760
[email protected] PO Box 10600 Grand Junction CO
81502-5600
ColoradoROCKY MOUNTAIN HEALTH PLANS
Rocky Mountain Health Plans 1876 Cost
Pharmacy Director Nolan Steve
1-970-244-7760 5182
[email protected] PO Box 10600 Grand Junction CO 81502
Colorado RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Colorado
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Colorado
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Colorado
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
MTMP Contacts, Updated 11/15/07 14
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Colorado
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Colorado
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Colorado
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Colorado
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Colorado
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Colorado
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Colorado
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Colorado
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Colorado
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Colorado
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Connecticut AETNA HEALTH INC. Aetna Health Inc. Local CCP
Director, Medicare Clinical Pharmacy Management Stern Jody L
1-386-963-2543
1-386-963-2544
5350 148th Place Wellborn FL
32094-2362
Connecticut
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Connecticut
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Connecticut
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
ConnecticutANTHEM HEALTH PLANS, INC
Anthem Blue Cross and Blue Shield Local CCP
Director of Clinical Operations Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Connecticut
ANTHEM INSURANCE COMPANIES, INC.
Anthem Insurance Companies, Inc. PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
MTMP Contacts, Updated 11/15/07 15
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Connecticut BLUE MEDICARERXAnthem Blue Cross and Blue Shield PDP
Clinical Pharmacist Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Connecticut
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Connecticut
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
ConnecticutEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Connecticut
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Connecticut
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Connecticut
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Connecticut
HEALTH NET LIFE INSURANCE COMPANY, INC. Health Net PFFS V.P., Operations
White, Pharm. D. Virginia E
1-916-463-9603
1-916-463-8056
10540 White Rock Rd., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
ConnecticutHEALTH NET OF CONNECTICUT
Health Net of Connecticut Local CCP
Senior Vice President, Chief Clinical Officer
White, Pharm D. Virginia E
1-916-463-9603
1-916-463-9750
10540 White Rock Rd., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Connecticut
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Connecticut
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Connecticut
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Connecticut
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
ConnecticutMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Connecticut
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
ConnecticutOXFORD HEALTH PLANS (CT), INC. SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Connecticut
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Connecticut
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Connecticut RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
MTMP Contacts, Updated 11/15/07 16
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
ConnecticutSENIOR WHOLE HEALTH, LLC
Senior Whole Health of Connecticut Local CCP
Director of Pharmacy Services Dichter Gayle
1-617-494-5353 6324
1-617-494-5599
58 Charles Street Cambridge MA 02141
Connecticut
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Connecticut
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Connecticut
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Connecticut
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Connecticut
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Connecticut
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Connecticut
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Connecticut
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
ConnecticutWELLCARE OF CONNECTICUT, INC. WellCare Local CCP Director of MTM Delancy Lisa
1-813-290-6200 3768
[email protected] PO Box 25858 Tampa FL
33622-5858
Connecticut
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Delaware AETNA HEALTH, INC Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Delaware
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Delaware
AETNA LIFE INSURANCE COMPANY Aetna Medicare Regional CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Delaware
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
DelawareBRAVO HEALTH MID-ATLANTIC INC. Bravo by Elder Health PFFS
Vice President, Pharmacy Services Owens Heather
1-410-864-4583
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
MTMP Contacts, Updated 11/15/07 17
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
DelawareBRAVO HEALTH MID-ATLANTIC, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
Delaware
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Delaware
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Delaware
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Delaware
DELAWARE PHYSICIANS CARE, INC.
Delaware Physicians Care Advantage Local CCP
Director Corporate Pharmacy Clark Mark
1-602-659-2062
4645 E Cotton Center BLVD Phoenix AZ 85004
Delaware
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
DelawareEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Delaware FIRST CARE, INC.Medi-CareFirst BlueCross BlueShield PDP
Director, Pharmacy Management Wong Winston
1-410-528-7897
1501 S. Clinton St 8th Floor Baltimore MD 21224
Delaware
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Delaware
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Delaware
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Delaware
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Delaware
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Delaware
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
DelawareMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Delaware
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Delaware
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Delaware
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
MTMP Contacts, Updated 11/15/07 18
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Delaware RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Delaware
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Delaware
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Delaware
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Delaware
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Delaware
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Delaware
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Delaware
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Delaware
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Delaware
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Delaware
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Delaware
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Florida AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Florida
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Florida
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Florida
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 19
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Florida AVMED, INCAvMed Medicare Preferred Local CCP
Manager of Clinical Pharmacy Kuznik Melissa
1-352-337-8785
1-352-337-8737
AvMed Health Plans
4300 NW 89 Blvd. Gainesville FL 32606
Florida AVMED, INC.AvMed Medicare Preferred PPO Local CCP
Manager of Clinical Pharmacy Kuznik Melissa
1-352-337-8785
1-352-337-8737
AvMed Health Plans
4300 NW 89th Blvd. Gainesville FL 32606
Florida
BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.
Blue Cross and Blue Shield of Florida Local CCP
Director, Government Pharmacy Programs Griffin Cynthia
1-904-905-6307
1-904-905-5907
4800 Deerwood Campus Pkwy
DCC Building 300, 3rd Floor Jacksonville, FL 32246
Florida
BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.
Blue Cross and Blue Shield of Florida, Inc. PDP
Director, Government Pharmacy Programs Griffin Cynthia
1-904-905-6307
1-904-905-5907
4800 Deerwood Campus Pkwy
DCC Building 300, 3rd Floor Jacksonville FL 32246
Florida
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
FloridaCAPITAL HEALTH PLAN Capital Health Plan Local CCP
Clinical Pharmacist Johnston April
1-850-523-7416
1-850-383-3495
[email protected] P.O. Box 15349 Tallahassee FL 32317
FloridaCARE PLUS HEALTH PLAN
CarePlus Health Plans, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
FloridaCITRUS HEALTH CARE, INC.
Citrus Health Care, Inc. Local CCP
Vice President Clinical Programs Schoening Shellie
1-402-965-8800 1110
1-402-965-9774
[email protected] PO BOX 407 Boys town NE 68010
Florida
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Florida
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
FloridaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Florida
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Florida
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
FloridaFLORIDA HEALTH CARE PLAN, INC.
Florida Health Care Plan, Inc. Local CCP
Pharmacy Administrator Klein Gary
1-800-352-9824 7173
1-386-676-7165
1340 Ridgewood Avenue Holly Hill FL 32117
FloridaFREEDOM HEALTH PLAN, INC. Freedom Health, Inc. Local CCP
Pharmacy Director Keilty Mike
1-888-796-0946
1-727-471-2108
5501 49th Street N St. Petersburg FL 33709
Florida
HEALTH FIRST HEALTH PLANS, INC.
Health First Medicare Plans Local CCP
Compliance Analyst Breisch Laura
1-321-434-5660
1-321-434-4361
6450 US Highway 1 Rockledge FL
32955-5747
Florida
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
FloridaHEALTH OPTIONS, INC
Health Options, Inc.\BCBSF Local CCP
Director, Government Pharmacy Programs Griffin Cynthia
1-904-905-6307
1-904-905-5907
4800 Deerwood Campus Pkwy
DCC Building 300, 3rd Floor Jacksonville FL 32246
Florida
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
MTMP Contacts, Updated 11/15/07 20
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Florida
HEALTHSUN HEALTH PLANS, INC.
HealthSun Health Plans, Inc. Local CCP
Compliance Officer de la Llama Marianela
1-305-234-9292
1-305-444-9148
1205 SW 37th Avenue Miami FL 33135
Florida
HUMANA HEALTH INSURANCE COMPANY OF FL, INC.
Humana Health Insurance Company Of Fl, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Florida
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Florida
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Florida
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
FloridaHUMANA MEDICAL PLAN, INC
Humana Medical Plan, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Florida
LEON MEDICAL CENTERS HEALTH PLANS, INC
Leon Medical Centers Health, Inc. Local CCP VP of UM Hernandez Henry
1-305-559-5366
1-305-644-2530
11501 SW 40th Street Miami FL 33165
FloridaMD MEDICARE CHOICE
PartnerCare Golden Advocate Plan Local CCP
Pharmacy Director Limberg Cari
1-813-901-9208 1101
1-813-901-9209
5501 West Waters Ave. Suite 401 Tampa FL 33634
Florida
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
Florida
MEDICA HEALTHCARE PLANS, INC.
Medica HealthCare Plans, Inc. Local CCP
Clinical Pharmacist Borges Alejandro M
1-305-460-0690
1-305-460-0613
4000 Ponce de Leon Blvd. Suite 650 Coral Gables FL 33146
FloridaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
FloridaMETCARE HEALTH PLANS, INC. AdvantageCare Local CCP
Chief Medical Officer Kenney, M.D. Robert
1-561-805-8500
1-561-805-8501
250 South Australian Avenue, Suite 400
West Palm Beach FL 33401
Florida
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
FloridaOPTIMUM HEALTHCARE, INC.
Optimum HealthCare, Inc. Local CCP
Supervisor, MTM DUR Programs Lawson Mark
1-215-937-5352
1-215-937-8450
200 Stevens Drive Philadelphia PA 19113
Florida
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Florida
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
FloridaPHYSICIANS UNITED PLAN, INC.
Physicians United Plan Local CCP
Pharmacy Clinical Services Hittich Lisa
1-765-526-2515
8407 Fallbrook Avenue #CAAF01
Attn: Network Management West Hills CA 91304
FloridaPREFERRED CARE PARTNERS INC.
Preferred Care Partners, Inc. Local CCP
Pharmacy Team Leader Sang Jamelle
1-305-670-8440 1220
1-786-888-1964
9100 S. Dadeland Blvd. Suite 1250 Miami FL 33156
Florida
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
MTMP Contacts, Updated 11/15/07 21
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
FloridaQUALITY HEALTH PLANS, INC
QUALITY HEALTH PLANS PDP
Director of Pharmacy McDowell John
1-727-945-8400 158
1-727-756-1080
2435 US Highway 19 Suite 470 Holiday FL 34691
FloridaQUALITY HEALTH PLANS, INC.
Quality Health Plans, Inc. Local CCP McDowell John
1-727-945-8400 158
1-727-945-8434
2435 US Hwy 19 Suite 470 Holiday FL 34691
Florida RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Florida
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Florida
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Florida
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
FloridaSUMMIT HEALTH PLAN, INC.
Summit Health Plan, Inc. Local CCP
Chief Medical Officer Hogan, MD Michael
1-954-858-3007
1-954-858-3695
1340 Concord Terrrace Sunrise FL 33323
Florida
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Florida
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Florida
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Florida
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Florida
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Florida
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Regional CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Florida
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St.
CA134-0404 Irvine CA 92614
Florida
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Florida
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Florida
UNITED HEALTHCARE OF FL, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Station CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 22
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Florida
UNITED HEALTHCARE OF FLORIDA INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Florida
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
FloridaUNIVERSAL HEALTH CARE, INC.
Universal Health Care, Inc. Local CCP
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO BOX 407 Boys town NE 68010
FloridaUNIVERSAL HEALTH CARE, INC.
Universal Health Care, Inc. Local CCP
Vice President, Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
Florida
VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.
Vista Healthplan of South Florida, Inc. Local CCP
Chief Medical Officer Hogan, MD Michael
1-954-858-3007
1-954-858-3695
1340 Concord Terrace Sunrise FL 33323
FloridaVISTA HEALTHPLAN, INC. Vista Healthplan, Inc. Local CCP
Chief Medical Officer Hogan, MD Michael
1-954-858-3007
1-954-858-3695
1340 Concord Terrace Sunrise FL 33323
FloridaWELL CARE OF FLORIDA, INC. WellCare Local CCP
Dir, Clinical Pharmacy delancy Lisa
1-813-290-6200 3768
[email protected] PO Box 25858 Tampa FL
33622-5858
Florida
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Florida
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
GeorgiaAETNA HEALTH INC.(GEORGIA) Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5250 148th Place Wellborn FL
32094-2362
Georgia
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5250 148th Place Wellborn FL
32094-2362
Georgia
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Georgia
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Georgia
ANTHEM INSURANCE COMPANIES, INC.
Anthem Insurance Companies, Inc. PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Georgia
ANTHEM INSURANCE COMPANIES, INC.
Blue Cross Blue Shield of Georgia PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Georgia
ARCADIAN HEALTH PLAN OF GEORGIA, INC.
Southeast Community Care Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
Georgia
BLUE CROSS BLUE SHIELD OF GEORGIA
Blue Cross Blue Shield Healthcare Plan of Georgia Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
MTMP Contacts, Updated 11/15/07 23
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Georgia
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO
Care Improvement Plus Regional CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Georgia
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Georgia
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Georgia
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Georgia
COVENTRY HEALTH CARE OF GEORGIA, INC. Advantra Local CCP Stephens Debbie
1-804-965-7658
Coventry Health Care Inc
4300 Cox Road Glen allen VA 23060
Georgia
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
GeorgiaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Georgia
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Georgia
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Georgia
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Georgia
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Georgia
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Georgia
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Georgia
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Georgia
INSTIL HEALTH INSURANCE COMPANY
Instil Health Insurance Company Local CCP
Director Medical Services Lachuk Lester
1-803-763-6559
1-803-935-1605
InStil Health Insurance Company
17 Technology Circle Columbia SC 29203
Georgia
INSTIL HEALTH INSURANCE COMPANY
InStil Health Insurance Company Regional CCP
Director Medical Services Lachuk Lester
1-803-763-6559
1-803-935-1605
17 Technology Circle Columbia SC 29203
Georgia
INSTIL HEALTH INSURANCE COMPANY
InStil Health Insurance Company PDP
Director Medical Services Lachuk Lester
1-803-763-6559
1-803-935-1605
17 Technology Circle, AG-790 Columbia SC 29203
Georgia
KAISER FOUNDATION HP OF GA, INC.
Kaiser Permanente Senior Advantage Local CCP
Pharmacy Director Washington Adrian
1-404-364-4765
3495 Piedmont Road NE Atlanta GA 30305
MTMP Contacts, Updated 11/15/07 24
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Georgia
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
GeorgiaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Georgia
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Georgia
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Georgia
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Georgia
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Georgia RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Georgia
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Georgia
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Georgia
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Georgia
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Georgia
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Georgia
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Georgia
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Georgia
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Georgia
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Georgia
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 25
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Georgia
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Georgia
UNITED HEALTHCARE OF GEORGIA, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-929-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Georgia
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
Georgia
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
GeorgiaWELLCARE OF GEORGIA, INC. WellCare Local CCP
Director, Clinical Pharmacy Delancy Lisa
1-813-290-6200 3768
[email protected] PO Box 25858 Tampa FL
33622-5858
Georgia
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Guam
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Hawaii
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Hawaii
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Hawaii ALOHACARE AlohaCare Local CCPClinical Pharmacist Nishimura Lee Rachel A
1-808-973-0828
1-808-973-0726
1357 Kapiolani Blvd., Suite 1250 Honolulu HI 96814
Hawaii
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Hawaii
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
HawaiiEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Hawaii
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Hawaii
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
HawaiiHAWAII MED. SRVC. ASSN. HMSA's 65C Plus 1876 Cost
HMSA Clinical Pharmacist Zarella Wendy
1-808-948-5544
1-808-948-5510
[email protected] 550B - PM
818 Keeaumoku St Honolulu HI 96814
Hawaii
HAWAII MEDICAL SERVICES ASSOCIATION
HMSA's Medicare Rx Plan PDP
HMSA Clinical Pharmacist Zarella Wendy
1-808-948-5544
1-808-948-5510
[email protected] 550B - PM
818 Keeaumoku St Honolulu HI 96814
MTMP Contacts, Updated 11/15/07 26
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Hawaii
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Hawaii
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Hawaii
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Hawaii
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Hawaii
KAISER FOUNDATION HP, INC.
Kaiser Foundation Health Plan, Inc. (Hawaii) Local CCP
Quality Management Coordinator Wilson Susan T
1-808-432-7533
Kaiser Permanente
501 Alakawa Street Honolulu HI 96819
Hawaii
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
HawaiiMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Hawaii
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Hawaii
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Hawaii RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Hawaii
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Hawaii
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Hawaii
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Hawaii
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Hawaii
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Hawaii
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Hawaii
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Hawaii
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main St
Mail Stop: CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 27
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Hawaii
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Regional CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main ST
Mail Stop: CA134-0404 Irvine CA 92614
Hawaii
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Hawaii
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Hawaii
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Idaho
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Idaho
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Idaho
BLUE CROSS OF IDAHO HEALTH SERVICES, INC
Blue Cross Of Idaho Hlth Services Inc Local CCP
Pharmacy Clinical Services Hettich Lisa
1-765-526-2515
8407 Fallbrook Ave # CAAF01 West Hills CA 91304
Idaho
BLUE CROSS OF IDAHO HEALTH SERVICES, INC.
Blue Cross Of Idaho Hlth Services Inc PFFS
Pharmacy Clinical Services Hettich Lisa
1-765-526-2515
8407 Fallbrook Ave # CAAF01
attn: Network Management West Hills CA
91304-3226
Idaho
BLUE CROSS OF IDAHO HLTH SERVICES INC
Blue Cross Of Idaho Hlth Services Inc Local CCP
Pharmacy Clinical Services Hettich Lisa
1-765-526-2515
8407 Fallbrook Ave #CAAF01
Attn: Network Management West Hills CA 91304
Idaho
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Idaho
EDUCATORS MUTUAL INSURANCE ASSOCIATION
Educators Mutual Insurance Association PDP Gallegos Jennifer
1-801-262-7476
852 East Arrowhead Lane Murray UT 84107
Idaho
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
IdahoEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Idaho
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Idaho
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Idaho
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
MTMP Contacts, Updated 11/15/07 28
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Idaho
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Idaho
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Idaho
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Idaho
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
IdahoMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Idaho
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Idaho
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Idaho
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
IdahoREGENCE BLUE SHIELD OF IDAHO
Regence BlueShield Of Idaho Local CCP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 110
PO Box 2560 Boise ID 87301
Idaho
REGENCE LIFE AND HEALTH INSURANCE COMPANY
Regence Life and Health PDP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 210
PO Box 2560 Boise ID 87301
Idaho RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Idaho
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Idaho
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Idaho
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Idaho
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Idaho
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Idaho
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Idaho
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
MTMP Contacts, Updated 11/15/07 29
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Idaho
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Idaho
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Idaho
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Idaho
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Idaho
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Idaho
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
IllinoisAETNA HEALTH OF ILLINOIS, INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Illinois
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
[email protected] 5350 148th Place Wellborn FL
32094-2362
Illinois
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Illinois
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
IllinoisBRAVO HEALTH MID-ATLANTIC, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
Illinois
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Illinois
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Illinois
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Illinois
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MTMP Contacts, Updated 11/15/07 30
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Illinois ESSENCE INC. Essence Inc. Local CCPdirector of QI and Compliance Keys Mary Kay
1-314-851-3664
[email protected] 12655 Olive 4th Floor saint louis MO 63141
IllinoisEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Illinois
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
IllinoisGROUP HEALTH PLAN, INC.
Group Health Plan, Inc. Local CCP Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Illinois
HARMONY HEALTH PLAN OF ILLINOIS, INC. WellCare Local CCP
Director, Clinical Pharmacy Delancy Lisa
1-813-290-6200 3768
[email protected] PO Box 25858 Tampa FL
33622-5858
Illinois
HCSC INSURANCE SERVICES COMPANY
HISC - Blue Cross Blue Shield of Illinois PDP
Pharmacy Director Nguyen Marie
1-651-286-4206
1-651-286-4403
Prime Therapeutics, LLC
1020 Discovery Road Eagen MN 55121
IllinoisHEALTH ALLIANCE MEDICAL PLANS
Health Alliance Medical Plans Local CCP
Director of Pharmacy Barrington Christina
1-217-337-8141
1-217-255-4598
[email protected] 301 S. Vine St. Urbana IL 61801
IllinoisHEALTH ALLIANCE MEDICAL PLANS
Health Alliance Medical Plans Local CCP
Director of Pharmacy Barrington Christina
1-217-337-8141
1-217-255-4598
[email protected] 301 S. Vine St. Urbana IL 61801
Illinois
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Illinois
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
IllinoisHEALTHSPRING, INC. HealthSpring, Inc. Local CCP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-291-7011
601 Mainstream Drive Nashville TN 37228
IllinoisHUMANA HEALTH PLAN, INC.
Humana Health Plan, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Illinois
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Illinois
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Illinois
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Illinois
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Illinois
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
IllinoisMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Illinois
MERCY HEALTH PLANS OF MISSOURI INC.
Mercy Health Plans, Inc. Local CCP
Director of Clinical Pharmacy Linsin Cathy
1-314-214-2489
1-314-214-8101
14528 S. Outer 40, Ste. 300 Chesterfield MO 63017
Illinois
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
MTMP Contacts, Updated 11/15/07 31
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
IllinoisOSF HEALTHPLANS, INC. OSF Care Advantage Local CCP
Associate Director of Pharmacy Porch William
1-309-677-8553
1-309-677-8354
7915 N Hale Ave, Ste D Peoria IL 61615
IllinoisOSF HEALTHPLANS, INC. OSF Care Preferred Local CCP
Associate Director of Pharmacy Porch Willaim
1-309-677-8553
1-309-677-8354
7915 N Hale Ave, Ste D Peoria IL 61615
Illinois
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Illinois
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Illinois
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Illinois RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Illinois
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Illinois
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Illinois
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Illinois
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Illinois
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Illinois
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Illinois
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Illinois
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Illinois
UNITED HEALTHCARE INS. COMPANY, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Illinois
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Illinois
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-3237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 32
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Illinois
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Illinois
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Illinois
UNITED HEALTHCARE OF THE MIDWEST, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Illinois
UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.
UnitedHealthcare Plan of the River Valley, Inc. Local CCP
Prescriptions Solutions Graham Phyllis
1-972-866-1501
1-972-866-1911
5001 LBJ Fwy, Suite 600 Dallas TX 75244
Illinois
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Illinois
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Indiana
ADVANTAGE HEALTH SOLUTIONS, INC.
Advantage Health Solutions, Inc. Local CCP
Director, Pharmacy and Data Analysis Musial Brian
1-317-573-6691
9490 Priority Way West Drive Indianapolis IN 46240
Indiana
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Indiana
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Indiana
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Indiana
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Indiana
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield Regional CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Indiana
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Indiana
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Indiana
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Indiana
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MTMP Contacts, Updated 11/15/07 33
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
IndianaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Indiana
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Indiana
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Indiana
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Indiana
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Indiana
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Indiana
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Indiana
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Indiana
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Indiana
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Indiana
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
IndianaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Indiana
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Indiana
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Indiana
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Indiana
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Indiana RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Indiana
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
MTMP Contacts, Updated 11/15/07 34
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Indiana
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Indiana
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Indiana
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Indiana
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Indiana
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Indiana
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Indiana
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Indiana
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Indiana
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Indiana
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Indiana
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Indiana
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Iowa
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Iowa
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Iowa
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Wellmark Blue Cross and Blue Shield of Iowa Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Iowa
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Wellmark Blue Cross and Blue Shield of Iowa PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
MTMP Contacts, Updated 11/15/07 35
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Iowa
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Iowa
COVENTRY HEALTH AND LIFE INS COMPANY
Coventry Health and Life Insurance Company Local CCP Stephens Debbie
1-804-965-7658
1-804-290-4831
[email protected] 4300 Cox Road Glen Allen VA 23060
Iowa
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Iowa
COVENTRY HEALTH CARE OF IOWA, INC.
Coventry Health Care of Iowa, Inc. Local CCP Stephens Debbie
1-804-965-7658
1-804-290-4831
[email protected] 4300 Cox Road Glen Allen VA 23060
Iowa
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
IowaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Iowa
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Iowa
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
IowaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Iowa
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Iowa
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Iowa
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Iowa
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Iowa
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
IowaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Iowa
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Iowa
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Iowa
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
MTMP Contacts, Updated 11/15/07 36
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Iowa
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Iowa RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Iowa
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Iowa
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Iowa
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Iowa
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Iowa
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Iowa
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Iowa
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Iowa
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Iowa
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Iowa
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Iowa
UNITED HEALTHCARE OF THE MIDLANDS, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St.
CA134-0404 Irvine CA 92614
Iowa
UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.
UnitedHealthcare Plan of the River Valley, Inc. Local CCP
Prescriptions Solutions Graham Phyllis
1-972-866-1501
1-972-866-1911
5001 LBJ Fwy, Suite 600 Dallas TX 75244
Iowa
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Iowa
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 37
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Kansas
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Kansas
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
KansasBLUE CROSS BLUE SHIELD OF KANSAS Blue MedicareRx PDP
Clinical Pharmacist Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Kansas
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Kansas
COVENTRY HEALTH AND LIFE INS. COMPANY
Coventry Health And Life Ins. Company Local CCP Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Kansas
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Kansas
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Kansas
COVENTRY HEALTH CARE OF KANSAS, INC.
Coventry Health Care of Kansas, Inc. Local CCP Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Kansas
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
KansasEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Kansas
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Kansas
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Kansas
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
KansasHUMANA HEALTH PLAN, INC.
Humana Health Plan, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kansas
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kansas
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kansas
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kansas
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MTMP Contacts, Updated 11/15/07 38
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Kansas
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
KansasMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Kansas
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Kansas
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Kansas
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Kansas
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Kansas RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Kansas
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Kansas
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Kansas
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Kansas
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Kansas
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Kansas
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Kansas
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Kansas
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Kansas
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Kansas
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 39
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Kansas
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Kansas
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Kentucky
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Kentucky
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Kentucky
ANTHEM HEALTH PLANS OF KENTUCKY, INC.
Anthem Blue Cross and Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Kentucky
ANTHEM HEALTH PLANS OF KENTUCKY, INC.
Anthem Blue Cross and Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Kentucky
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield Regional CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Kentucky
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Kentucky
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Kentucky
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Kentucky
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
KentuckyEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Kentucky
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Kentucky
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Kentucky
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Kentucky
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Kentucky
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MTMP Contacts, Updated 11/15/07 40
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Kentucky
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kentucky
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kentucky
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kentucky
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Kentucky
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
KentuckyMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Kentucky
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Kentucky
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Kentucky
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Kentucky
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Kentucky RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Kentucky
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Kentucky
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Kentucky
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Kentucky
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Kentucky
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Kentucky
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Kentucky
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
MTMP Contacts, Updated 11/15/07 41
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Kentucky
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Kentucky
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Kentucky
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
KentuckyUNIVERSITY HEALTH CARE, INC. Passport Advantage Local CCP
Supervisor, Pharmacy DUR/MTM Lawson Mark
1-215-937-5352
1-215-937-8450
200 Stevens Drive 4th Floor Philadelphia PA 19113
Kentucky
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Kentucky
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Louisiana
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Louisiana
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Louisiana
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Louisiana
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Louisiana
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Louisiana
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
LouisianaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Louisiana
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Louisiana
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Louisiana
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
MTMP Contacts, Updated 11/15/07 42
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Louisiana
HUMANA HEALTH BENEFIT PLAN OF LA, INC.
Humana Health Benefit Plan of LA, Inc. PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Louisiana
HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC
Humana Health Benefit Plan Of Louisiana Inc Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Louisiana
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Louisiana
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Louisiana
LOUISIANA HEALTH SERVICE AND INDEMNITY COMPANY
Blue Cross and Blue Shield of Louisiana PDP
Medicare Part D Pharmacy Manager McLean Gionne
1-800-417-8164
1-877-837-5922
5525 Reitz Avenue Baton Rouge LA 70809
Louisiana
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
LouisianaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Louisiana
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Louisiana
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Louisiana
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Louisiana
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Louisiana RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Louisiana
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Louisiana
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Louisiana
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Louisiana
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Louisiana
TENET CHOICES, INC. / PEOPLES HEALTH NETWORK Peoples Health Local CCP
Clinical Pharmacist Smith Shannon
1-504-849-4500 8887
1-504-849-6901
Three Lakeway Center
3838 N Causeway Blvd, Suite 2200 Metairie LA 70002
Louisiana
TENET CHOICES, INC. / PEOPLES HEALTH NETWORK Peoples Health Local CCP PharmD Smith Shannon
1-504-849-4500 8887
1-504-849-6901
Three Lakeway Center
3838 N Causeway Blvd, Suite 2200 Metairie LA 70002
MTMP Contacts, Updated 11/15/07 43
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Louisiana
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Louisiana
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Louisiana
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Louisiana
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Louisiana
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Louisiana
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
LouisianaVANTAGE HEALTH PLAN, INC.
Vantage Health Plan, Inc. Local CCP
Director of UR/QM Halley Melissa
1-318-361-0900 110
[email protected] 130 DeSiard St Suite 300 Monroe LA 71201
Louisiana
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
LouisianaWELLCARE OF LOUISIANA, INC. WellCare Local CCP
Director, Clinical Pharmacy Delancy Lisa
1-813-290-6200 3768
[email protected] PO Box 25858 Tampa FL
33622-5858
Louisiana
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Maine
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Maine
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Maine
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Maine
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
MaineARCADIAN HEALTH PLAN, INC.
Northeast Community Care Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
Maine
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Maine
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MTMP Contacts, Updated 11/15/07 44
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
MaineEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Maine
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Maine
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MaineFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Maine
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Maine
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Maine
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Maine
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MaineMARTINS POINT GENERATIONS, LLC
Martin's Point Generations Advantage Local CCP
Director of Pharmacy Services Takach Michael
1-207-791-3745
1-207-828-2494
331 Veranda Street
PO Box 9746 Portland ME
04104-5040
Maine
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MaineMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Maine
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Maine
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Maine
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Maine RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Maine
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Maine
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Maine
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Maine
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
MTMP Contacts, Updated 11/15/07 45
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Maine
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Maine
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Maine
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Maine
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Maine
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Maine
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Maine
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MarylandAETNA HEALTH INC. (MARYLAND) Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-386-963-2544
5350 148th Place Wellborn FL
32094-2362
Maryland
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Maryland
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Maryland
AETNA LIFE INSURANCE COMPANY Aetna Medicare Regional CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Maryland
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Maryland
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
MarylandAMERIGROUP MARYLAND, INC.
AMERIGROUP Community Care Local CCP
AVP Clinical Pharmacy Radzin Richard
1-757-518-3152
4425 Corporation Lane, #300 Virginia Beach VA 23462
MarylandBRAVO HEALTH MID-ATLANTIC INC. Bravo by Elder Health Local CCP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
MTMP Contacts, Updated 11/15/07 46
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
MarylandBRAVO HEALTH MID-ATLANTIC INC. Bravo by Elder Health PFFS
Vice President, Pharmacy Services Owens Heather
1-410-864-4583
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
MarylandBRAVO HEALTH MID-ATLANTIC, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
Maryland
CARE IMPROVEMENT PLUS OF MARYLAND, INC.
Care Improvement Plus Local CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Maryland
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Maryland
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Maryland
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Maryland
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MarylandEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Maryland FIRST CARE, INC.Medi-CareFirst BlueCross BlueShield PDP
Director, Pharmacy Management Wong Winston
1-410-528-7897
1501 S. Clinton St 8th Floor Baltimore MD 21224
Maryland
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Maryland
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Maryland
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Maryland
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Maryland
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Maryland
KAISER FNDN HP OF THE MID-ATLANTIC STS
Kaiser Permanente Medicare Plus 1876 Cost
Pharmacy Director Downard Susan
1-301-816-6835
2101 East Jefferson St Rockville MD 20852
MarylandMARYLAND CARE - MEDICARE, INC.
Golden Advantage Plus Local CCP
Director Corporate Pharmacy Clark Mark
1-602-659-2062
4645 E Cotton Center Blvd Phoenix AZ 85040
Maryland
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MarylandMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MTMP Contacts, Updated 11/15/07 47
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Maryland
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Maryland
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Maryland
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Maryland RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Maryland
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Maryland
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Maryland
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Maryland
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Maryland
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Maryland
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Maryland
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Maryland
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Maryland
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Maryland
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Maryland
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Maryland
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Massachusetts
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 48
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Massachusetts
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Massachusetts
BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.
Blue Cross And Blue Shield Of Massachusetts, Inc. Local CCP
Clinical Pharmacist Flori, RPh Jeremy J
1-617-246-6654
Landmark Center
401 Park Drive Boston MA 02215
Massachusetts
BLUE CROSS and BLUE SHIELD OF MA HMO BLUE, INC.
Blue Cross and Blue Shield of Massachusetts, Inc. Local CCP
Clinical Pharmacist Flori, RPh Jeremy J
1-617-246-6654
Landmark Center
401 Park Drive Boston MA 02215
Massachusetts BLUE MEDICARERX
Blue Cross and Blue Shield of Massachusetts PDP
Clinical Pharmacist Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
MassachusettsCOMMONWEALTH CARE ALLIANCE
Commonwealth Care Alliance Local CCP
Director of Pharmacy Shebli Basem
1-617-426-0600
1-617-426-1311
30 Winter Street, 7th Floor Boston MA 02108
Massachusetts
COMMONWEALTH CARE ALLIANCE, INC.
Commonwealth Care Alliance, Inc. Demo
Director of Pharmacy Shebli Basem
1-617-426-0600
1-617-426-1311
30 Winter Street, 7th Floor Boston MA 02108
Massachusetts
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Massachusetts
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Massachusetts
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MassachusettsEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Massachusetts
FALLON COMMUNITY HEALTH PLAN
Fallon Community Health Plan Local CCP Pharmacist Haji Mojgan
1-800-333-2535 69916
One Chestnut Place
10 Chestnut Street Worcester MA 01608
Massachusetts
FALLON COMMUNITY HEALTH PLAN
Fallon Community Health Plan Local CCP Pharmacist Haji Mojgan
1-800-333-2535 69916
One Chestnut Place
10 Chestnut Street Worcester MA 01608
Massachusetts
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Massachusetts
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MassachusettsHARVARD PILGRIM HEALTH CARE INC.
HARVARD PILGRIM HEALTH CARE INC. PFFS
Medical Director, Pharmacy Minkoff, MD Neil
1-617-509-0170
1-617-509-6031
1600 Crown Colony Drive Quincy MA 02169
Massachusetts
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Massachusetts
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
MTMP Contacts, Updated 11/15/07 49
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Massachusetts
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Massachusetts
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Massachusetts
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MassachusettsMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Massachusetts
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Massachusetts
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Massachusetts
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Massachusetts RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
MassachusettsSENIOR WHOLE HEALTH, LLC Senior Whole Health Demo
Director of Pharmacy Services Dichter Gayle
1-617-494-5353 6324
1-617-494-5599
58 Charles Street, 2nd Floor Cambridge MA 02141
Massachusetts
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Massachusetts
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
MassachusettsTUFTS ASSOCIATED HMO, INC. Tufts Health Plan Local CCP
Senior Clinical Pharmacist Calcagni Christophe
1-617-972-9400 3217
1-617-673-0133
705 Mt Auburn Street Watertown MA 02472
MassachusettsTUFTS ASSOCIATED HMO, INC. Tufts Health Plan Local CCP
Senior Clinical Pharmacist Calcagni Christophe
1-617-972-9400 3217
1-617-673-0133
705 Mt Auburn Street Watertown MA 02472
Massachusetts
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Massachusetts
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Massachusetts
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Massachusetts
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Massachusetts
UNITED HEALTHCARE INSURANCE COMPANY United Health Group Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 50
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Massachusetts
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Massachusetts
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Massachusetts
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Massachusetts
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Michigan
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Michigan
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Michigan
ALLIANCE HEALTH AND LIFE INSURANCE, CO
Alliance Medicare PPO Local CCP
Director, Pharmacy Care Management Pindolia Vanita
1-248-443-8849
2850 W. Grand Blvd. Detroit MI 48202
Michigan
BLUE CARE NETWORK OF MICHIGAN Blue Care Network Local CCP
Pharmacy Manager Cavanaugh Jeanne
1-248-455-3592
1-248-455-3692
20500 Civic Center Drive Southfield MI 48076
Michigan
BLUE CROSS BLUE SHIELD OF MICHIGAN
Blue Cross Blue Shield of Michigan PFFS Director Welford Lisa
1-248-448-6172
27300 West 11 Mile Road MC B776 Southfield MI 48034
Michigan
BLUE CROSS BLUE SHIELD OF MICHIGAN
Blue Cross Blue Shield of Michigan PDP Director Welford Lisa
1-248-448-6172
27300 West Eleven Mile Road MC B776 Southfield MI 48034
Michigan
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
Michigan
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Michigan
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Michigan
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Michigan
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MichiganEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Michigan
FIDELIS SECURECARE OF MICHIGAN
Fidelis SecureCare Of Michigan Local CCP Wilborn Jerome
1-734-779-1680
1-734-779-1681
38777 West Six Mile Road Suite 207 Livonia MI 48152
MTMP Contacts, Updated 11/15/07 51
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Michigan
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MichiganHEALTH ALLIANCE PLAN OF MICHIGAN HAP Senior Plus Local CCP
Director, Pharmacy Care Management Pindolia Vanita
1-248-443-8849
2850 West Grand Blvd Detroit MI 48202
Michigan
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
MichiganHEALTHPLUS OF MICHIGAN
HealthPlus of Michigan Local CCP
Pharmacy Project and Development Manager Sopo Deborah A
1-810-230-2276
1-810-720-2757
2050 S. Linden Road Flint MI 48532
Michigan
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Michigan
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Michigan
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Michigan
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Michigan
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MichiganMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MichiganMIDWEST HEALTH PLAN, INC. Midwest Advantage Local CCP
SR. DIRECTOR OF HEALTH SERVICES ANDERSON ELLEN
1-313-586-6033
1-313-586-6045
5050 SCHAEFER ROAD DEARBORN MI 48126
Michigan
MOLINA HEALTHCARE OF MICHIGAN
Molina Healthcare of Michigan Local CCP
Director, Pharmacy SCHATZMAN BENJAMIN
1-562-951-1509 1509
1-562-437-9315
ONE GOLDEN SHORE DRIVE LONG BEACH CA 90802
Michigan
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Michigan
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
MichiganPARAMOUNT CARE, INC Paramount Elite Local CCP
Coordinator, Prescription Drug PRogram Bogner Craig M
1-419-887-2249
1-419-887-2015
1901 Indian Wood Circle Maumee OH 43537
Michigan
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Michigan PRIORITY HEALTH PriorityMedicare Local CCPDirector, Pharmacy Wassom Rhonda
1-616-464-8832
1231 East Beltline, NE Grand Rapids MI 49525
Michigan
PRIORITY HEALTH INSURANCE COMPANY PriorityMedicareRx PDP
Director, Pharmacy Wassom Rhonda
1-616-464-8832
1231 East Beltline NE Grand Rapids MI 49525
MTMP Contacts, Updated 11/15/07 52
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Michigan
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Michigan RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Michigan
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Michigan
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Michigan
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Michigan
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Michigan
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Michigan
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Michigan
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Michigan
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Michigan
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Michigan
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Michigan
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Michigan
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Minnesota
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Minnesota
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 53
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Minnesota
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross and Blue Shield of Minnesota Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Minnesota
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross and Blue Shield of Minnesota PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Minnesota BLUE PLUS SecureBlue DemoManager, Special Needs Plans Nesset Diane
1-651-662-2133
3400 Yankee Drive Eagan MN 55122
Minnesota
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Minnesota
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MinnesotaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Minnesota
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Minnesota
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MinnesotaFIRST PLAN OF MINNESOTA First Plan Blue Demo
Director of Pharmacy First Plan of Minnesota McDannold Roger
1-218-740-2330 7263
1-218-834-9531
SuperiorHealth Pharmacy
1010 Fourth Street Two Harbors MN 55616
MinnesotaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
MinnesotaGROUP HEALTH PLAN, INC. HealthPartners Local CCP
Director Pharmacy Services Cooper Susan
1-952-967-5818
8170 33rd Avenue South
PO Box 1309 Minneapolis MN
55440-1309
Minnesota
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Minnesota HEALTHPARTNERS HealthPartners 1876 Cost
Director Pharmacy Services Cooper Susan
1-952-967-5818
8170 33rd Avenue South
PO Box 1309 Minneapolis MN
55440-1309
Minnesota HEALTHPARTNERS
HealthPartners Classic MN Senior Health Options Demo
Director Pharmacy Services Cooper Sue
1-952-967-5818
8170 33rd Avenue South, PO Box 1309
MS: 21111B Minneapolis MN 55440
Minnesota
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
MinnesotaHMO MINNESOTA D/B/A BLUE PLUS CareBlue Local CCP
Manager, Special Needs Plans Nesset Diane
1-651-662-2133
1-651-662-2133
3400 Yankee Drive Eagan MN 55122
Minnesota
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Minnesota
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MinnesotaITASCA MEDICAL CARE Itasca Medical Care Demo MTM, Manager Moyna Audry
1-847-559-3999
1-847-559-4733
9501 E. Shea Blvd. Scottsdale AZ 85260
MTMP Contacts, Updated 11/15/07 54
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Minnesota
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MinnesotaMEDICA HEALTH PLANS Medica Dual Solution Demo Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
MinnesotaMEDICA HEALTH PLANS Medica Health Plans PFFS Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
Minnesota
MEDICA INSURANCE COMPANY
Medica Insurance Company 1876 Cost Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
MinnesotaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MinnesotaMETROPOLITAN HEALTH PLAN
Metropolitan Health Plan MSHO Demo
Director of Medical Administration Moore Ned
1-612-596-0725
1-612-904-4265
400 South 4th Street Suite 201 Minneapolis MN 55415
MinnesotaMETROPOLITAN HEALTH PLAN
North Star Advantage / North Star Advantage Plus Local CCP
Director of Medical Administration Moore Ned
1-612-596-0725
1-612-904-4265
400 South 4th Street Suite 201 Minneapolis MN 55415
Minnesota
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Minnesota
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Minnesota
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
MinnesotaPRIMEWEST HEALTH SYSTEM
Primewest Health System Demo
Pharmacy Director Government Programs Nguyen Marie
1-651-286-4206
1-651-286-4403
Prime Therapeutics, LLC
PO Box 64812, Mail Route PWEST St. Paul MN 55164
Minnesota
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Minnesota RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Minnesota
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
MinnesotaSOUTH COUNTRY HEALTH ALLIANCE
South Country Health Alliance Demo Nguyen Marie
1-651-286-4206
1-651-286-4424
Prime Therapeutics Inc.
1020 Discovery Road No. 100 Eagan MN 55121
MinnesotaSOUTH COUNTRY HEALTH ALLIANCE
South Country Health Alliance Local CCP Nguyen Marie
1-651-286-4206
1-651-286-4424
Prime Therapeutics Inc.
1020 Discovery Road No. 100 Eagan MN 55121
Minnesota
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Minnesota
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Minnesota UCARE MINNESOTA UCare Minnesota Demo Medical Director Christianson Craig1-612-676-3375
1-612-676-6501
[email protected] PO Box 52 Minneapolis MN 55440
MTMP Contacts, Updated 11/15/07 55
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Minnesota UCARE MINNESOTA UCare Minnesota Demo Medical Director Christianson Craig1-612-676-3375
1-612-676-6501
[email protected] PO Box 52 Minneapolis MN 55440
Minnesota UCARE MINNESOTA UCare Minnesota Local CCP Medical Director Christianson Craig1-612-676-3375
1-612-676-6501
[email protected] PO Box 52 Minneapolis MN 55440
Minnesota
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Minnesota
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Minnesota
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Minnesota
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Minnesota
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Minnesota
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Minnesota
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Mississippi
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Mississippi
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Mississippi
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Mississippi
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Mississippi
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Mississippi
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MississippiEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Mississippi
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MTMP Contacts, Updated 11/15/07 56
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Mississippi
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Mississippi
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
MississippiHEALTHSPRING OF TENNESSEE, INC. Healthspring, Inc. Local CCP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Mississippi
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Mississippi
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Mississippi
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Mississippi
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MississippiMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Mississippi
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Mississippi
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Mississippi
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Mississippi
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Mississippi RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Mississippi
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Mississippi
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Mississippi
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Mississippi
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Mississippi
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
MTMP Contacts, Updated 11/15/07 57
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Mississippi
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Mississippi
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Mississippi
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Mississippi
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Mississippi
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MississippiWINDSOR HEALTH PLAN, INC Windsor Rx PDP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
MississippiWINDSOR HEALTH PLANS, INC.
Windsor Medicare Extra Local CCP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
Missouri
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Missouri
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Missouri
ANTHEM INSURANCE COMPANIES, INC.
Blue Cross Blue Shield of Missouri PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Missouri
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
Care Improvement Plus Regional CCP Moyna Audrey
1-847-555-9399
1-847-559-4733
2211 Sanders Road Suite 100 Northbrook IL 60062
Missouri
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Missouri
COVENTRY HEALTH AND LIFE INS. COMPANY
Coventry Health And Life Ins. Company Local CCP Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Missouri
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Missouri
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Missouri
COVENTRY HEALTH CARE OF KANSAS, INC.
Coventry Health Care of Kansas, Inc. Local CCP Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MTMP Contacts, Updated 11/15/07 58
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Missouri
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
Missouri ESSENCE INC. Essence Inc. Local CCPdirector of QI and Compliance Keys Mary Kay
1-314-851-3664
[email protected] 12655 Olive 4th Floor saint louis MO 63141
MissouriEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Missouri
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MissouriGROUP HEALTH PLAN, INC.
Group Health Plan, Inc. Local CCP Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Missouri
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Missouri
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Missouri
HEALTHY ALLIANCE LIFE INSURANCE COMPANY
Blue Cross Blue Shield of Missouri PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
MissouriHUMANA HEALTH PLAN, INC.
Humana Health Plan, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Missouri
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Missouri
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Missouri
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Missouri
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Missouri
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MissouriMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Missouri
MERCY HEALTH PLANS OF MISSOURI INC.
Mercy Health Plans, Inc. Local CCP
Director of Clinical Pharmacy Linsin Cathy
1-314-214-2489
1-314-214-8101
14528 S. Outer 40, Ste. 300 Chesterfield MO 63017
Missouri
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Missouri
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Missouri
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Missouri
PREMIER HEALTH INSURANCE COMPANY, INC.
Premier Health Insurance Company, Inc. Local CCP
Director of Clinical Pharmacy Linsin Cathy
1-314-214-2489
1-314-214-8101
14528 S. Outer 40, Ste. 300 Chesterfield MO 63017
MTMP Contacts, Updated 11/15/07 59
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Missouri
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Missouri RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Missouri
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Missouri
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Missouri
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Missouri
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Missouri
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Missouri
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Missouri
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Missouri
UNITED HEALTHCARE INS. COMPANY, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Missouri
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Missouri
UNITED HEALTHCARE OF THE MIDWEST, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Missouri
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Missouri
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Montana
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Montana
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 60
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Montana
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross and Blue Shield of Montana Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Montana
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross and Blue Shield of Montana PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Montana
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Montana
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
MontanaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Montana
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Montana
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MontanaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Montana
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Montana
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Montana
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Montana
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Montana
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MontanaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MontanaNEW WEST HEALTH SERVICES New West Medicare Local CCP Quality Director Wassell Monica
1-406-457-2210
1-406-457-2255
130 Neill Avenue Helena MT 59601
Montana
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Montana
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Montana
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
MTMP Contacts, Updated 11/15/07 61
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Montana RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Montana
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Montana
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Montana
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Montana
STERLING LIFE INSURANCE COMPANY (MT)
Sterling Life Insurance Company PFFS
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Montana
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Montana
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Montana
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Montana
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Montana
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Montana
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Montana
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Nebraska
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Nebraska
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Nebraska
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross and Blue Shield of Nebraska Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Nebraska
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross and Blue Shield of Nebraska PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
MTMP Contacts, Updated 11/15/07 62
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Nebraska
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Nebraska
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Nebraska
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
NebraskaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Nebraska
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Nebraska
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
NebraskaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Nebraska
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Nebraska
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Nebraska
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Nebraska
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Nebraska
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
NebraskaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Nebraska
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Nebraska
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Nebraska
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Nebraska RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Nebraska
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
MTMP Contacts, Updated 11/15/07 63
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Nebraska
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Nebraska
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Nebraska
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Nebraska
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Nebraska
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Nebraska
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Nebraska
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Nebraska
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Nebraska
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Nebraska
UNITED HEALTHCARE OF THE MIDLANDS, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St.
CA134-0404 Irvine CA 92614
Nebraska
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Nevada
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Nevada
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Nevada
ANTHEM INSURANCE COMPANIES, INC.
Blue Cross Blue Shield of Nevada PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Nevada
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Nevada
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
MTMP Contacts, Updated 11/15/07 64
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Nevada
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Nevada
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
NevadaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Nevada
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Nevada
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
NevadaHEALTH PLAN OF NEVADA, INC. Senior Dimensions Local CCP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
NevadaHEALTH PLAN OF NEVADA, INC. Senior Dimensions Demo
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Nevada
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
NevadaHOMETOWN HEALTH PLAN Senior Care Plus Local CCP Pharmacist Britt Judy
1-775-982-3089
1-775-982-3748
830 Harvard Way Reno NV 89502
NevadaHOMETOWN HEALTH PLAN Senior Care Plus Local CCP Pharmacist Britt Judy
1-775-982-3089
1-775-982-3748
830 Harvard Way Reno NV 89502
Nevada
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Nevada
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Nevada
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
NevadaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Nevada
MOLINA HEALTHCARE OF NEVADA, INC.
Molina Healthcare of Nevada Local CCP
Corporate Director of Pharmacy Services Schatzman Benjamin
1-562-951-1509
One Golden Shore Drive Long Beach CA 90802
Nevada
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Nevada
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
NevadaPACIFICARE OF NEVADA, INC
Secure Horizons Medicare Advantage Plan Local CCP
VP, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Nevada
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
MTMP Contacts, Updated 11/15/07 65
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Nevada RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Nevada
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.
Sierra Nevada Spectrum Regional CCP
Director, Phrmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Nevada
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. Sierra Spectrum Local CCP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Nevada
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Nevada
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Nevada
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Nevada
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Nevada
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Nevada
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Nevada
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Nevada
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Nevada
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Nevada
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
Nevada
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Nevada
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
New Hampshire
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 66
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Hampshire
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New Hampshire
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
New Hampshire
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
New Hampshire
ANTHEM INSURANCE COMPANIES, INC.
Anthem Insurance Companies, Inc. PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
New Hampshire
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
New Hampshire
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
New HampshireEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
New Hampshire
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New Hampshire
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New HampshireFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
New HampshireHARVARD PILGRIM HEALTH CARE INC.
HARVARD PILGRIM HEALTH CARE INC. PFFS
Medical Director, Pharmacy Minkoff, MD Neil
1-617-509-0170
1-617-509-6031
1600 Crown Colony Drive Quincy MA 02169
New Hampshire
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
New Hampshire
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
New Hampshire
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New Hampshire
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New Hampshire
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
New HampshireMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
New Hampshire
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
MTMP Contacts, Updated 11/15/07 67
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Hampshire
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Hampshire
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
New Hampshire RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
New Hampshire
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
New Hampshire
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New Hampshire
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New Hampshire
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
New Hampshire
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
New Hampshire
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
New Hampshire
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Hampshire
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
New Hampshire
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
New JerseyAETNA HEALTH, INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New Jersey
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New Jersey
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New Jersey
AETNA LIFE INSURANCE COMPANY Aetna Medicare Regional CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 68
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Jersey
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New Jersey
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
New JerseyAMERICHOICE OF NEW JERSEY, INC
AmeriChoice Personal Care Plus Local CCP
Pharmacy Director Hatch Vanessa
1-703-226-3126
1-703-506-3556
8045 Leesburg Pike Vienna VA 22182
New JerseyAMERIHEALTH HMO, INC. AmeriHealth Rx PDP
Senior Clinical Pharmacist DaCosta Maribel
1-215-241-7928
1901 Market Street 22nd Fl. Philadelphia PA 19103
New JerseyAMERIHEALTH HMO_INC AmeriHealth 65 Local CCP
Manager, Population Health & Wellness Siejak Kimberly
1-215-241-4016
1901 Market Street 29th Fl. Philadelphia TX 19103
New Jersey
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
New Jersey
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
New Jersey
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
New JerseyEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
New Jersey
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New Jersey
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New Jersey
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
New Jersey
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
New Jersey
HORIZON HEALTHCARE OF NEW JERSEY, INC.
Horizon Blue Cross Blue Shield of New Jersey, Inc. Local CCP
Director, Clinical Programs Jan Saira
1-973-466-4575
3 Penn Plaza East - PP 13Q Newark NJ
07105-2200
New Jersey
HORIZON HEALTHCARE SERVICES DBA HORIZON BCBS NJ
Horizon Blue Cross Blue Shield of New Jersey, Inc. PDP
Director, Clinical Programs Jan Saira
1-973-466-4575
Three Penn Plaza East PP-13Q Newark NJ 07105
New Jersey
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New Jersey
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MTMP Contacts, Updated 11/15/07 69
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Jersey
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
New JerseyMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
New Jersey
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
New JerseyOXFORD HEALTH PLANS (NJ), INC. SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Jersey
OXFORD HEALTH PLANS OF NEW JERSEY, INC Evercare Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St.
CA134-0404 Irvine CA 92614
New Jersey
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Jersey
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
New JerseyQMEDCARE OF NEW JERSEY, INC QMedCare Local CCP VP Admin Keller Vivian
1-732-544-5544 1302
1-732-544-5404
25 Christopher Way Eatontown NJ 07724
New Jersey RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
New Jersey
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
New Jersey
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
New Jersey
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New Jersey
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New Jersey
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
New Jersey
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
New Jersey
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
New Jersey
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Jersey
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insuance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 70
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Jersey
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
New Jersey
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
New Mexico
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New Mexico
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
New Mexico
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
New MexicoEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
New Mexico
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New Mexico
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New Mexico
HCSC INSURANCE SERVICES COMPANY
HISC - Blue Cross Blue Shield of New Mexico Local CCP
Pharmacy Director, Government Programs Nguyen Marie
1-651-286-4206
1-651-283-4403
Prime Therapeutics
1020 Discovery Road, No.100 Egan MN 55121
New Mexico
HCSC INSURANCE SERVICES COMPANY
HISC - Blue Cross Blue Shield of New Mexico PDP
Pharmacy Director Nguyen Marie
1-651-286-4206
1-651-286-4403
Prime Therapeutics, LLC
1020 Discovery Road Eagen MN 55121
New Mexico
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
New Mexico
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
New Mexico
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New Mexico
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New MexicoLOVELACE HEALTH SYSTEM, INC. Lovelace Senior Plan Local CCP
Director Pharmacy Services Murvin Thomas
1-505-232-1804
4101 Indian School Rd, NE Albuquerque NM 87110
New Mexico
LOVELACE INSURANCE COMPANY
Lovelace Insurance Company Local CCP
Director: Pharmacy Services Murvin Thomas E
1-505-232-1804
1-505-262-7390
4101 Indian School R. NE Suite 110S Albuquerque NM 87111
New Mexico
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
New MexicoMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MTMP Contacts, Updated 11/15/07 71
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Mexico
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
New Mexico
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Mexico
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
New MexicoPRESBYTERIAN HEALTH PLAN
Presbyterian Senior Care Local CCP
Pharmacy Director Georgopoulos Larry
1-505-923-5530
1-505-923-5540
[email protected] P.O. Box 27489 Albuquerque NM
87125-7489
New Mexico
PRESBYTERIAN INSURANCE COMPANY, INC.
Presbyterian MediCare PPO Local CCP
Pharmacy Director Georgopoulos Larry
1-505-923-5530
1-505-923-5201
[email protected] P.O. Box 26267 Albuquerque NM
87125-6267
New Mexico
PRESBYTERIAN INSURANCE COMPANY, INC.
Presbyterian Prescription Drug Plan PDP
Pharmacy Director Georgopoulos Larry
1-505-923-5530
1-505-923-5540
[email protected] P.O. Box 26267 New Mexico NM
87125-6267
New Mexico RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
New Mexico
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
New Mexico
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
New Mexico
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New Mexico
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New Mexico
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
New Mexico
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
New Mexico
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
New Mexico
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Mexico
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New Mexico
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main St
Mail Stop: CA134-0404 Irvine CA 92614
New Mexico
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 72
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New Mexico
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
New Mexico
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
New Mexico
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
New York AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-386-963-2544
5350 148th Place Wellborn FL
32094-2362
New York
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New York
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New York
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
New YorkAFFINITY HEALTH PLAN, INC. Affinity Health Plan Local CCP
Clinical Pharmacist Anzisi Lisa
1-718-794-7173
1-718-536-3383
2500 Halsey Street Bronx NY 10461
New York
AMERICAN PROGRESSIVE LIFE AND HEALTH INS CO NY
American Progressive Life & Health Ins Co of NY PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
New York
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
New YorkAMERICHOICE OF NEW YORK, INC
AmeriChoice Personal Care Plus Local CCP
Director Pharmacy Management Hatch Vanessa
1-703-226-3126
8045 Leesburg Pike Vienna VA 22182
New York
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
New York
CAMBRIDGE LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care Inc
4300 Cox Road Glen Allen VA 23060
New York
CAMBRIDGE LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director. Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New York
CAMBRIDGE LIFE INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
New York
CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.
CDPHP Medicare Choice Local CCP
Academic Intervention Pharmacist Winn Sue
1-518-641-3225
1-518-641-3208
500 Patroon Creek Blvd Albany NY 12206
MTMP Contacts, Updated 11/15/07 73
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New YorkCDPHP UNIVERSAL BENEFITS, INC.
CDPHP Medicare RxCare PDP
Academic Intervention Pharmacist Winn Sue
1-518-641-3225
1-518-641-3208
500 Patroon Creek Blvd Albany NY 12206
New York
COMPREHENSIVE CARE MANAGEMENT CORP.
Comprehensive Care Management Corp. Local CCP M.D. Eisenberg Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive Franklin Lakes NJ 07417
New York
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
New York ELDERPLAN, INC. Elderplan, Inc. Local CCPAVP Medical Management Montella Lynda
1-718-921-8409
1-718-921-8813
6323 Seventh Avenue Brooklyn NY 11220
New YorkELDERPLAN, INC. - SHMO Elderplan, Inc. Demo
AVP Medical Management Montella Lynda
1-718-921-8409
1-718-921-8813
6323 Seventh Avenue Brooklyn NY 11220
New York
EMPIRE HEALTHCHOICE ASSURANCE, INC.
Empire BlueCross BlueShield Local CCP
Director of Clinical Operations Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
New York
EMPIRE HEALTHCHOICE ASSURANCE, INC.
Empire BlueCross BlueShield PFFS Hettich Lisa
1-765-526-2515
8407 Fallbrook Avenue West Hills CA 91304
New York
EMPIRE HEALTHCHOICE HMO, INC.
Empire BlueCross BlueShield HMO Local CCP
Director of Clinical Operations Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
New York
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
New YorkEXCELLUS HEALTH PLAN, INC Simply Prescriptions PDP
Director, FLRx Clinical Operations Rocco Darlene
1-585-327-7544
[email protected] 165 Court Street Rochester NY 14647
New YorkEXCELLUS HEALTH PLAN, INC.
Excellus Health Plan, Inc. Local CCP
Director, FLRx Clinical Operations Rocco Darlene
1-585-327-7544
[email protected] 165 Court Street Rochester NY 14647
New YorkEXCELLUS HEALTH PLAN, INC.
Excellus Health Plan, Inc. Local CCP
Director, FLRx Clinical Operations Rocco Darlene
1-585-327-7544
[email protected] 165 Court Street Rochester NY 14647
New YorkEXCELLUS HEALTH PLAN, INC.
Excellus Health Plan, Inc. 1876 Cost
Director, FLRx Clinical Operations Rocco Darlene
1-585-327-7544
[email protected] 165 Court Street Rochester NY 14647
New YorkEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
New York
FIRST UNITED AMERICAN LIFE INSURANCE COMPANY
First United American Life Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
New York
GHI (GROUP HEALTH INCORPORATED)
GHI Medicare Prescription Drug Plan PDP Manager Sebastian Tobin
1-212-615-4567
1-212-563-8500
441 Ninth Avenue New York NY 10001
New YorkGROUP HEALTH INCORPORATED
GHI Medicare Choice PPO Local CCP Manager Sebastian Tobin
1-212-615-4567
[email protected] 441 Ninth Ave New York NY 10001
New York
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
New YorkHEALTHNOW NEW YORK INC Senior Blue Local CCP
Director Clinical Pharmacy Services Baker Philip
1-716-887-8765
257 West Genesee Street Buffalo NY 14202
New YorkHEALTHNOW NEW YORK INC.
HealthNow New York Inc. PDP
Director Clinical Pharmacy Services Baker Philip
1-716-887-8765
257 West Genesee Street Buffalo NY 14202
MTMP Contacts, Updated 11/15/07 74
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New YorkHEALTHNOW NEW YORK INC.
Traditional Blue Medicare PPO Local CCP
Director Clinical Pharmacy Services Baker Philip
1-716-887-8765
257 West Genesee Street Buffalo NY 14202
New York
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
New YorkHIP HEALTH PLAN OF NEW YORK
HIP Insurance Company of New York PDP Director Aral Jasmine
1-646-447-7186
[email protected] 55 Water Street New York NY 10041
New YorkHIP OF GREATER NEW YORK
HIP Health Plan of Greater New York Local CCP Aral Jasmine
1-646-447-7186
[email protected] 55 Water Street New York NY 11401
New York
HUMANA INSURANCE COMPANY OF NEW YORK
Humana Insurance Company of New York PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New York
HUMANA INSURANCE COMPANY OF NEW YORK
Humana Insurance Company of New York PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
New York
INDEPENDENT HEALTH ASSOCIATION, INC. Independent Health Local CCP
Utilization Management Pharmacist Verrall Kelly
1-716-635-4885
1-716-631-0149
511 Faber Lakes Drive Buffalo NY 14221
New York
INDEPENDENT HEALTH BENEFITS CORP Independent Health Local CCP
Utilization Management Pharmacist Verrall Kelly
1-716-635-4885
1-716-631-0149
511 Farber Lakes Drive Buffalo NY 14221
New York
INDEPENDENT HEALTH BENEFITS CORPORATION Independent Health PFFS
Utilization Management Pharmacist Verrall Kelly
1-716-635-4885
1-716-631-0149
511 Farber Lakes Drive Buffalo NY 14221
New YorkLIBERTY HEALTH ADVANTAGE, INC.
Liberty Health Advantage Local CCP
Vice President Clinical Programs Schoening Shellie
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boystown NE 68010
New YorkMANAGED HEALTH, INC.
Healthfirst Medicare Plan Local CCP
VP, Regulatory Affairs Helzner Christine
1-646-313-8967
1-646-313-4644
25 Broadway, 9th Floor New York NY 10004
New York
MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
New YorkMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
New YorkMVP HEALTH PLAN, INC, MVP Gold Local CCP
Pharmacy Director Colin Wendy
1-585-327-2577
1-585-258-8621
[email protected] 259 Monroe Ave Rochester NY 14607
New York
NEIGHBORHOOD HEALTH PROVIDERS LLC
Neighborhood Health Providers Local CCP
Vice President, Care Management Campbell Deborah S
1-704-329-7065 4402
1-704-329-0211
4944 Pkwy. Plaza Blvd. Suite 110 Charlotte NC 28217
New York
NEW YORK STATE CATHOLIC HLTH PLAN INC Fidelis Local CCP CMO Michelson Marco
1-718-896-6500 1036
9525 Queens Blvd. Rego Park NY 11374
New York
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
New YorkOXFORD HEALTH PLANS (NY) INC. SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New York
ROCHESTER AREA HEALTH MAINTENANCE ORG.
Preferred Care GoldAnywhere Local CCP
Pharmacy Coordinator Colin Wendy
1-585-327-2577
259 Monroe Ave. Rochester NY 14607
MTMP Contacts, Updated 11/15/07 75
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New York
ROCHESTER AREA HMO/ DBA PREFERRED CARE Preferred Care Gold Local CCP
Clinical Pharmacy Coordinator Colin Wendy
1-585-327-2577
259 Monroe Ave. Rochester NY 14607
New York RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
New YorkSENIOR WHOLE HEALTH, LLC
Senior Whole Health of New York Local CCP
Director of Pharmacy Services Dichter Gayle
1-617-494-5353 6324
1-617-494-5599
58 Charles Street, 2nd Floor Cambridge MA 02141
New York
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
New York
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New York
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
New YorkTOUCHSTONE HEALTH HMO, INC. Health Net Of NY Local CCP VP, Pharmacy Mednick Darlene
1-212-294-1653
1-212-294-8210
[email protected] 14 Wall Street New York NY 10005
New YorkTOUCHSTONE HEALTH HMO, INC. Touchstone Health Local CCP VP of Pharmacy Mednick Darlene
1-212-294-1653
1-212-294-8210
[email protected] 14 Wall Street New York NY 10005
New York
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
New York
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
New York
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New York
UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New York
UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK SecureHorizons Regional CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main St
Mail Stop: CA134-0404 Irvine CA 92614
New York
UNITED HEALTHCARE INSURANCE COMPANY OF NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
New York
UNITED HEALTHCARE OF NEW YORK, INC. SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
New York VNS CHOICE VNS CHOICE Select Local CCP Brown Nancy1-401-333-3987 7941
1-401-335-7941
PharmaCare Management Services, Inc.
695 George Washington Highway Lincoln RI 02865
New York
WELLCARE HEALTH INSURANCE OF NEW YORK, INC. WellCare PFFS
Director Medication Therapy Management Delancey Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 76
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
New York
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
New YorkWELLCARE_OF NEW YORK, INC. WellCare Local CCP
Director, Clinical Pharmacy Delancy Lisa
1-813-290-6200 3917
[email protected] PO Box 25858 Tampa FL
33622-5858
North Carolina
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
North Carolina
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
North Carolina
BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA
Blue Cross Blue Shield of North Carolina PDP
Director, Health Services Miller Debra
1-336-201-4310
Blue Cross and Blue Shield of North Carolina
P.O. Box 17509 Winston-Salem NC
27116-7509
North Carolina
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
North Carolina
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
North Carolina
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
North Carolina
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
North CarolinaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
North Carolina
FIDELIS SECURECARE OF NORTH CAROLINA
Fidelis SecureCare of North Carolina Local CCP Medical Director Herman Chris
1-877-372-8080
1-877-372-8081
11301 Carmel Commons Boulevard Suite 215 Charlotte NC 28226
North Carolina
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
North Carolina
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
North Carolina
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
North Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
North Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
North Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MTMP Contacts, Updated 11/15/07 77
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
North Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
North Carolina
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
North CarolinaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
North Carolina
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
North Carolina
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
North Carolina
PARTNERS NATIONAL HEALTH PLANS OF NC INC
PARTNERS Medicare Options Local CCP
Director Health Services Miller Debra
1-336-201-4310
5660 University Parkway Winston-Salem NC 27105
North Carolina
PARTNERS NATIONAL HEALTH PLANS OF NC, INC.
PARTNERS Medicare Choice Local CCP
Director Health Services Miller Debra
1-336-201-4310
5660 University Parkway Winston-Salem NC 27105
North Carolina
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
North Carolina
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
North Carolina RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
North Carolina
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
North Carolina
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
North Carolina
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
North Carolina
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
North Carolina
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
North Carolina
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
North Carolina
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
North Carolina
UNITED HEALTHCARE INS. COMPANY, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 78
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
North Carolina
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
North Carolina
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
North Carolina
UNITED HEALTHCARE OF NORTH CAROLINA SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-747-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
North Carolina
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
North Carolina
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
North Dakota
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
North Dakota
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
North Dakota
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross Blue Shield of North Dakota Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
North Dakota
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross Blue Shield of North Dakota PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
North Dakota
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
North Dakota
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
North Dakota
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
North DakotaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
North Dakota
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
North Dakota
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
North DakotaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
MTMP Contacts, Updated 11/15/07 79
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
North Dakota
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
North Dakota
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
North Dakota
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
North Dakota
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
North Dakota
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
North DakotaMEDICA HEALTH PLANS Medica Health Plans PFFS Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
North Dakota
MEDICA INSURANCE COMPANY
Medica Insurance Company 1876 Cost Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
North DakotaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
North Dakota
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
North Dakota
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
North Dakota
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
North Dakota RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
North Dakota
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
North Dakota
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
North Dakota
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
North Dakota
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
North Dakota
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
North Dakota
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
North Dakota
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 80
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
North Dakota
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
North Dakota
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Northern Mariana Islands
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
OhioAETNA HEALTH OF (OHIO) Aetna Medicare Local CCP
Director, Medicare clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Ohio
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
21094-2362
Ohio
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Ohio
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Ohio
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield Regional CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Ohio
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Ohio
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
Ohio
COMMUNITY INSURANCE COMPANY
Anthem Blue Cross and Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Ohio
COMMUNITY INSURANCE COMPANY
Anthem Blue Cross and Blue Shield Local CCP Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Ohio
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Ohio
COVENTRY HEALTH AND LIFE INS. COMPANY
Carelink Advantra PPO Local CCP Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Ohio
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Ohio
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MTMP Contacts, Updated 11/15/07 81
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Ohio
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
OhioEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Ohio
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
OhioGATEWAY HEALTH PLAN OF OHIO, INC.
Gateway Health Plan Medicare Assured Local CCP
Clinical Pharmacist Scalise Lorraine
1-412-255-1349
1-888-245-2049
600 Grant Street, 41st Floor Pittsburgh PA 15219
Ohio
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Ohio
HEALTH PLAN OF THE UPPER OHIO VALLEY The Health Plan Local CCP
Director pharmacy services neal steve
1-740-695-7638
1-740-695-7925
[email protected] The Health Plan
52160 National Road East St. Clairsville OH 43950
Ohio
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
OhioHOMETOWN HEALTH PLAN The Health Plan Local CCP
Director pharmacy services neal steve
1-740-695-7686
1-740-695-8103
[email protected] The Health Plan
52160 National Road East St. Clairsville OH 43950
Ohio
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Ohio
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Ohio
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Ohio
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Ohio
KAISER FOUNDATION HP OF OHIO
Kaiser Foundation Health Plan of Ohio 1876 Cost
Clinical Pharmacy Specialist Dzurec Maryann
1-216-265-4407
1-216-265-4415
[email protected] 12301 Snow Rd.
Clinical Pharmacy Services Parma OH 44130
Ohio
MCKINLEY LIFE INSURANCE COMPANY
PrimeTime Health Plan Local CCP
Clinical Pharmacist Kmiecik Karen
1-330-363-2250
2600 Sixth Street SW Canton OH 44710
Ohio
MCKINLEY LIFE INSURANCE COMPANY
PrimeTime Health Plan Local CCP
Clinical Pharmacist Kmiecik Karen
1-330-363-2250
2600 Sixth Street SW Canton OH 44710
Ohio
MCKINLEY LIFE INSURANCE COMPANY
PrimeTime Health Plan PFFS
Clinical Pharmacist Kmiecik Karen
1-330-363-2250
2600 Sixth Street SW Canton OH 44710
Ohio
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
OhioMEDICAL MUTUAL OF OHIO
Advantage Plans from Medical Mutual of Ohio Local CCP
Mgr. Pharmaceutical Benefits Hendricks Chad
1-216-687-2882
2060 East Ninth Street Cleveland OH 44115
OhioMEDICAL MUTUAL OF OHIO
Advantage Plans from Medical Mutual of Ohio PDP
Mgr. Pharmaceutical Benefits Hendricks Chad
1-216-687-2882
2060 East Ninth Street Cleveland OH 44115
OhioMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MTMP Contacts, Updated 11/15/07 82
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
OhioMT. CARMEL HEALTH PLAN, INC. MediGold Local CCP
Director, Clinical Operations Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Ohio
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Ohio
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
OhioPARAMOUNT CARE, INC Paramount Elite Local CCP
Coordinator, Prescription Drug PRogram Bogner Craig M
1-419-887-2249
1-419-887-2015
1901 Indian Wood Circle Maumee OH 43537
Ohio
PARAMOUNT INSURANCE COMPANY
Paramount Prescription Drug Plan PDP Bogner Craig
1-419-887-2249
1-419-887-2015
1901 Indian Wood Circle Maumee OH 43537
Ohio
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Ohio
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Ohio RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Ohio
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Ohio
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Ohio
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Ohio
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Ohio SUMMACARE INC. SummaCare Local CCPPharmacy Director Colligan Tim
1-800-996-8411
1-330-996-8580
[email protected] P.O. Box 3620 Akron OH
44309-3620
Ohio
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Ohio
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Ohio
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Ohio
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Ohio
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Local CCP
Vice President, Chief Medical Officer Addiego Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 83
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Ohio
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Ohio
UNITED HEALTHCARE OF OHIO, INC. SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr. M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
OhioUPMC HEALTH BENEFITS, INC UPMC Health Plan PDP
Manager, Medicare Operations Cain John O
1-412-454-5539
1-412-454-5539
112 Washington Place Pittsburgh PA 15219
Ohio
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Ohio
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Oklahoma AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody l
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Oklahoma
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Oklahoma
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
OklahomaARKANSAS COMMUNITY CARE
Arkansas Community Care, Inc. Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
OklahomaCOMMUNITY CARE HMO, INC
CommunityCare Senior Health Plan Local CCP QI Analyst Beyersdorf Lee Ann
1-918-594-5295 4053
1-918-877-9729
218 W. 6th Street Tulsa OK 74119
Oklahoma
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Oklahoma
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Oklahoma
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Oklahoma
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
OklahomaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Oklahoma
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MTMP Contacts, Updated 11/15/07 84
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
OklahomaGLOBALHEALTH, INC.
Generations Healthcare Local CCP
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Oklahoma
HCSC INSURANCE SERVICES COMPANY
Blue Cross And Blue Shield Of Oklahoma Local CCP
Clinical Pharmacy Manager Hettich Lisa
1-765-526-2515 6346
1-765-391-1023
8407 Fallbrook Ave West Hills CA 91304
Oklahoma
HCSC INSURANCE SERVICES COMPANY
BLUE CROSS AND BLUE SHIELD OF OKLAHOMA PDP
Pharmacy Director Nguyen Marie
1-651-286-4403
Prime Therapeutics
1020 Discovery Road Eagen MN 55121
Oklahoma
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Oklahoma
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Oklahoma
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Oklahoma
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Oklahoma
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Oklahoma
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
OklahomaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Oklahoma
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Oklahoma
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
OklahomaPACIFICARE OF OKLAHOMA, INC.
Secure Horizons Medicare Advantage Plan Local CCP
VP, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Oklahoma
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Oklahoma
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Oklahoma RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
OklahomaSELECTCARE OF OKLAHOMA, INC.
SelectCare of Oklahoma Local CCP
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Oklahoma
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
MTMP Contacts, Updated 11/15/07 85
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Oklahoma
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Oklahoma
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Oklahoma
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Oklahoma
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Oklahoma
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Oklahoma
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Oklahoma
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Oklahoma
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Oklahoma
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Oregon
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Oregon
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Oregon
ASURIS NORTHWEST HEALTH
Asuris Northwest Health PDP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle
PO Box 2560 Boise ID 87301
OregonATRIO HEALTH PLANS ATRIO MyAdvantage Local CCP
Director of Compliance and Quality Management
Hergenrader, RN Diana D
1-541-672-8620 5383
1-541-672-8670
500 SE Cass Ave. Suite 230 Roseburg OR 97470
Oregon
CLEAR CHOICE HEALTH PLANS, INC.
Clear Choice Health Plans Local CCP Olsen Colleen
1-541-385-5315 4980
1-541-382-4225
2650 NE Courtney Dr. Bend OR 97701
Oregon
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Oregon
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
OregonEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
MTMP Contacts, Updated 11/15/07 86
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Oregon
FAMILYCARE HEALTH PLANS, INC.
FamilyCare Health Plans, Inc. Local CCP
Director of Pharmacy Operations Thanem Michael
1-503-471-2147
1-503-471-2197
2121 SW Broadway Suite 300 Portland OR 97201
Oregon
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Oregon
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
OregonFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Oregon
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Oregon
HEALTH NET LIFE INSURANCE COMPANY
Health Net Medicare Advantage Local CCP
Vice President, Operations - HNPS
White, Pharm. D. Virginia E
1-916-463-9603
10540 White Rock Rd., Ste 280
Mail Top: CA-175-02-02
Rancho Cordova CA 95670
OregonHEALTH PLAN OF CAREOREGON, INC.
CareOregon Advantage Local CCP
Clinical Pharmacy Program Coordinator Benkstein Kristen
1-503-416-1734
1-503-416-1428
CareOregon Advantage
315 SW Fifth Avenue, Suite 900 Portland OR 97204
Oregon
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Oregon
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Oregon
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Oregon
KAISER FOUNDATION HP OF THE N W
Kaiser Foundation Health Plan of the NW Local CCP
Pharmacy Benefit Manager Logan Steve
1-503-261-7980
5725 NE 138th Ave Portland OR 97230
Oregon
KAISER FOUNDATION HP OF THE N W
Kaiser Foundation Health Plan of the NW Demo
Pharmacy Benefit Manager Logan Steve
1-503-261-7980
5725 NE 138th Ave Portland OR 97230
Oregon
MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.
Marion Polk Community Health Plan Advantage Local CCP
Medical Management Coordinator Morgan Roberta
1-503-371-7701 145
1-503-371-8046
245 Commercial St. SE, Ste. 220 Salem OR 97301
Oregon
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
OregonMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Oregon
MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION CareSource Local CCP
Director of Medical Affairs Ackerman Cynthia
1-541-471-4106
1-541-471-1524
740 SE 7th Street Grants Pass OR 97526
Oregon
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
OregonODS HEALTH PLAN, INC. ODS Advantage Local CCP
Vice President Medical Services Richardson Robin
1-503-243-4491
1-503-948-5557
601 SW Second Ave Portland OR 97204
MTMP Contacts, Updated 11/15/07 87
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
OregonODS HEALTH PLAN, INC. ODS Advantage Rx PDP
Vice President Medical Services Richardson Robin
1-503-243-4491
1-503-948-5557
601 SW Second Ave Portland OR 97204
Oregon
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
OregonPACIFICARE OF OREGON, INC.
Secure Horizons Medicare Advantage Plan Local CCP
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Oregon
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
OregonPROVIDENCE HEALTH PLAN
Providence Health Plan Local CCP
PHARMACY DIRECTOR NOONAN HELEN M
1-503-574-5708
1-503-574-8646
[email protected] PO BOX 3125 PORTLAND OR
97208-3125
Oregon
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Oregon
REGENCE BLUECROSS BLUESHIELD OF OR
Regence BlueCross BlueShield of Oregon Local CCP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 210
PO Box 2560 Boise ID 87301
Oregon RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Oregon
SAMARITAN HEALTH PLANS, INC.
Samaritan Advantage Health Plan Local CCP
Pharmacy Coordinator Tracer Tamatha
1-541-768-5207
1-541-768-4294
[email protected] PO Box M Corvallis OR 97339
Oregon
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Oregon
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Oregon
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Oregon
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Oregon
TRILLIUM COMMUNITY HEALTH PLAN Trillium Advantage Local CCP
Clinical Pharmacist Wick Shauna
1-541-485-2155
1800 Millrace Drive Eugene OR 97403
Oregon
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Oregon
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Oregon
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Oregon
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 88
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Oregon
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Oregon
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Oregon
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Oregon
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Oregon
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Oregon
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Pennsylvania AETNA HEALTH INC Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Pennsylvania
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Pennsylvania
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Pennsylvania
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Pennsylvania
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
PennsylvaniaAMERIHEALTH HMO_INC AmeriHealth 65 Local CCP
Manager, Population Health & Wellness Siejak Kimberly
1-215-241-4016
1901 Market Street 29th Fl. Philadelphia PA 19103
Pennsylvania
AVALON INSURANCE COMPANY
Avalon Insurance Company PDP
Pharmacy Manager Frost Lisa
1-717-703-8466
2500 Elmerton Avenue Harrisburg PA 17177
Pennsylvania
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
PennsylvaniaBRAVO HEALTH PENNSYLVANIA INC. Bravo by Elder Health Local CCP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
MTMP Contacts, Updated 11/15/07 89
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Pennsylvania
CAPITAL ADVANTAGE INSURANCE COMPANY
Capital Advantage Insurance Company Local CCP
Pharmacy Manager Frost Lisa
1-717-703-8466
2500 Elmerton Avenue Harrisburg PA 17177
Pennsylvania
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Pennsylvania
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Pennsylvania
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Pennsylvania
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
PennsylvaniaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Pennsylvania
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
PennsylvaniaGATEWAY HEALTH PLAN, INC.
Gateway Health Plan Medicare Assured Local CCP
Clinical Pharmacist Scalise Lorraine
1-412-255-1349
1-888-245-2049
600 Grant Street - 41st Floor Pittsburgh PA
15219-2704
PennsylvaniaGEISINGER HEALTH PLAN
Geisinger Health Plan Gold Local CCP
Clinical Pharmacist Collins Vanessa
1-570-214-9606
1-570-214-6768
100 N. Academy Ave. Danville PA
17822-3245
Pennsylvania
GEISINGER INDEMNITY INSURANCE COMPANY
Geisinger Health Plan Gold Choice PFFS
Clinical Pharmacist Collins Vanessa
1-570-214-9606
1-570-214-6768
100 North Academy Avenue Danville PA
17822-3245
Pennsylvania
GEISINGER INDEMNITY INSURANCE COMPANY
Geisinger Health Plan Gold Preferred Local CCP
Clinical Pharmacist Collins Vanessa L
1-570-214-9606
1-570-214-6768
100 North Academy Avenue Danville PA
17822-3245
Pennsylvania
GEISINGER INDEMNITY INSURANCE COMPANY
Geisinger Health Plan Gold Rx PDP
Clinical Pharmacist Collins Vanessa
1-570-214-9606
1-570-271-5268
100 North Academy Avenue Danville PA
17822-3245
Pennsylvania
HEALTH ASSURANCE PENNSYLVANIA, INC. Advantra PPO Local CCP Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Pennsylvania
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Pennsylvania
HEALTHAMERICA PENNSYLVANIA, INC.
HealthAmerica Advantra Local CCP Stephens Debbie
1-804-965-7658
Coventry Health Care Inc
4300 Cox Road Glen Allen VA 23060
Pennsylvania
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
PennsylvaniaHIGHMARK SENIOR RESOURCES INC.
Highmark Senior Resources Inc. PDP
Manager, Clinical Pharmacy Services Culley Eric
1-412-544-4005
1-412-544-4092
120 Fifth Avenue Ste. 1812 Pittsburgh PA 15222
MTMP Contacts, Updated 11/15/07 90
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Pennsylvania HIGHMARK, INC. Highmark Inc. Local CCPManager- Clincal Services Culley Eric
1-412-544-4005
1-412-544-7546
120 Fifth Avenue Place Suite 1812 Pittsburgh PA
15222-3099
Pennsylvania
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Pennsylvania
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Pennsylvania
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
PennsylvaniaINDEPENDENCE BLUE CROSS Personal Choice 65 Local CCP
Manager, Population Health & Wellness Siejak Kimberly
1-215-241-4016
1901 Market Street 29th Fl. Philadelphia PA 19103
PennsylvaniaKEYSTONE HEALTH PLAN CENTRAL,INC.
Keystone Health Plan Central, Inc. Local CCP Frost Lisa
1-717-703-8466
2500 Elmerton Avenue Harrisburg PA 17177
PennsylvaniaKEYSTONE HEALTH PLAN EAST, INC. Keystone 65 Local CCP
Manager, Population Health & Wellness Siejak Kimberly
1-215-241-4016
1901 Market Street 29th Fl. Philadelphia PA 19103
PennsylvaniaKEYSTONE HEALTH PLAN WEST, INC.
Keystone Health Plan West, Inc. Local CCP
Manager - Clinical Services Culley Eric
1-412-544-4005
1-412-544-7546
120 Fifth Avenue Place Suite 1812 Pittsburgh PA
15222-3099
Pennsylvania
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
PennsylvaniaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Pennsylvania
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Pennsylvania
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Pennsylvania
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Pennsylvania
QCC INS CO D/B/A AMERIHEALTH INS CO
AmeriHealth Advantage PDP
Supervisor, Pharmacy DUR/MTM Lawson Mark
1-215-937-5352
200 Stevens Drive 4th Floor Philadelphia PA 19113
Pennsylvania
QCC INS CO D/B/A AMERIHEALTH INS CO AmeriHealth Rx PDP
Senior Clinical Pharmacist DaCosta Maribel
1-215-241-7928
1901 Market Street 22nd Floor Philadelphia PA 19103
Pennsylvania RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
PennsylvaniaSENIOR PARTNERS BY BRAVO HEALTH Senior Partners Local CCP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
Pennsylvania
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Pennsylvania
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
MTMP Contacts, Updated 11/15/07 91
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Pennsylvania
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Pennsylvania
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Pennsylvania
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Pennsylvania
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Pennsylvania
UNISON HEALTH PLAN OF PENNSYLVANIA, INC. Unison Advantage Local CCP Brekosky Robert
1-412-349-6167
1-412-457-1616
[email protected] Unison Plaza
1001 Brinton Road Pittsburgh PA 15221
Pennsylvania
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Pennsylvania
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Pennsylvania
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Pennsylvania
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Pennsylvania
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Local CCP
Director - Clinical Programs & Education Anderson Michael J
1-952-936-3112
1-952-936-4933
UnitedHealth Group
9900 Bren Road East MN008-T500 Minnetonka MN 55343
Pennsylvania
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer Addiego Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Pennsylvania
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Pennsylvania
UNIVERSITY OF PITTSBURGH MEDICAL CENTER UPMC Health Plan Local CCP
Manager, Medicare Operations Cain John
1-412-454-5539
1-412-454-7711
112 Washington Place Suite 800 Pittsburgh PA 15219
PennsylvaniaUPMC HEALTH BENEFITS, INC UPMC Health Plan PDP
Manager, Medicare Operations Cain John
1-412-454-5539
112 Washington Place Pittsburgh PA 15219
PennsylvaniaUPMC HEALTH NETWORK UPMC Health Plan Local CCP
Manager, Medicare Operations Cain John
1-412-454-5539
1-412-454-7711
112 Washington Place Suite 800 Pittsburgh PA 15219
Pennsylvania
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 92
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Pennsylvania
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Puerto RicoAMERICAN HEALTH, INC.
American Health Medicare Local CCP
Pharmacy and Delegated Entities Manager Hernandez Carmen
1-787-620-1919 4054
1-787-620-0929
American Health Medicare
P.O. Box 11320 San Juan PR 00922
Puerto RicoAUXILIO PLATINO, INC. Auxilio Platino Local CCP
Clinical Pharmacist Smith Shannon
1-504-849-4500 8887
1-504-849-6901
Three Lakeway Center
3838 N Causeway Blvd, Suite 2200 Metairie LA 70002
Puerto Rico
COOPERATIVA DE SEGUROS DE VIDA DE PUERTO RICO
Cooperativa de Seguros de Vida de PR (COSVI) Local CCP
WHI Account Manager Rodriguez Awilda
1-787-751-3663
1-787-751-3713
273 Ave Ponce de Le≤n Suite 801
San Juan, Puerto Rico 00917-1923 SAN JUAN PR
00917-1923
Puerto Rico
COOPERATIVE DE SEGUROS DE VIDA DE PUERTO RICO
Cooperativa de Seguros de Vida de PR, COSVI PDP Pharmacist Rodriguez Ivonne
1-787-751-5656
[email protected] PO Box 363428 San Juan PR
00936-3428
Puerto RicoEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Puerto RicoFIRST MEDICAL HEALTH PLAN, INC
First Medical Health Plan, Inc. PDP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Puerto RicoFIRST MEDICAL HEALTH PLAN, INC.
First Medical Health Plan, Inc. Local CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Puerto RicoFIRST MEDICAL HEALTH PLAN, INC.
First Medical Health Plan, Inc. Local CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Puerto Rico
HUMANA HEALTH PLANS OF PUERTO RICO INC
Humana Health Plans Of Puerto Rico Inc Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Puerto Rico
HUMANA INSURANCE OF PUERTO RICO, INC
Humana Insurance Of Puerto Rico, Inc PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Puerto Rico
HUMANA INSURANCE OF PUERTO RICO, INC
Humana Insurance of Puerto Rico, Inc PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Puerto Rico
MAPFRE LIFE INSURANCE COMPANY
MAPFRE LIFE Insurance Company Local CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Puerto RicoMCS ADVANTAGE INC. MCS Classicare Local CCP
Research Academic Pharmacist Santiago Edgardo
1-787-758-2500 4907
1-787-622-7766
[email protected] PO Box 191720 San Juan PR
00919-1720
Puerto RicoMCS ADVANTAGE, INC. MCS Classicare PDP
Research Academic Pharmacist Santiago Edgardo
1-787-758-2500 4907
1-787-622-7766
[email protected] PO Box 191720 San Juan PR
00919-1720
Puerto Rico
MCS LIFE INSURANCE COMPANY MCS Classicare PFFS
Research Academic Pharmacist Santiago Edgardo
1-787-758-2500 4907
1-787-622-7766
[email protected] PO Box 191720 San Juan PR
00919-1720
Puerto Rico
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
Puerto RicoMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MTMP Contacts, Updated 11/15/07 93
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Puerto RicoMMM HEALTHCARE, INC.
Medicare y Mucho Más Local CCP Vice President Bou Clara I
1-787-622-3000 8602
1-787-625-3370
Bechara Industrial Park, Marginal Avenue
Kennedy Segarra Street Bldg., No. 411 San Juan PR 00936
Puerto Rico
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Puerto Rico
PHARMACY INSURANCE CORPORATION OF AMERICA
Pharmacy Insurance Corporation of America - PICA PDP Clinical Echevarria Irma
1-787-625-4343 4711
1-787-625-4363
[email protected] PO Box 70232 San Juan PR
00936-8232
Puerto Rico
PREFERRED MEDICARE CHOICE, INC.
Preferred Medicare Choice, Inc. Local CCP
Vice President, Pharmacy Services Bou Clara I
1-787-622-3000 8602
1-787-625-3370
Bechara Industrial Park
Marginal Avenue, Kennedy Segarra Street Bldg., No. 411 San Juan PR 00936
Puerto Rico
PREFERRED MEDICARE CHOICE, INC.
Preferred Medicare Choice, Inc. PDP
VP Pharmacy Services Bou Clara
1-787-622-3000 8602
1-787-625-3375
350 Chardon Ave.
Suite 500 Torre Chardon. San Juan PR 00918
Puerto RicoRED MEDICA DE PUERTO RICO, INC. Red Med Local CCP Valle Oliveras JosΘ W
1-787-620-7772
1-787-620-7774
Capital Center Building, South Tower, Ste 704
239 Ave Arterial Hostos San Juan PR
00918-1476
Puerto RicoSDM HEALTHCARE MANAGEMENT, INC.
Salud Dorada con Medicare Local CCP Medical Director Irizarry Maria
1-787-999-4848
1-787-999-7941
[email protected] P.O Box 3078 Bayamon PR
00960-3078
Puerto Rico
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Puerto Rico TRIPLE-S, INC. Triple-S PDP
Manager for Member Education Department Fernßndez Zenaida
1-787-749-4012
1-787-749-4093
PO BOX 363628 San Juan PR
00936-3628
Puerto Rico TRIPLE-S, INC. Triple-S, Inc. Local CCP
Manager for Member Education Department Fernßndez Zenaida
1-787-749-4012
1-787-749-4093
[email protected] PO Box 363628 San Juan PR
00936-3628
Puerto Rico TRIPLE-S, INC. Triple-S, Inc. Local CCP
Manager for Member Education Department Fernßndez Zenaida
1-787-749-4012
1-787-749-4093
[email protected] PO Box 363628 San Juan PR
00936-3628
Puerto Rico
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Rhode Island
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Rhode Island
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 94
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Rhode Island
BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND
Blue Cross & Blue Shield Of Rhode Island Local CCP
MTM Clinical Interventions Manager Hettich Lisa
1-765-526-2515
1-765-391-1023
8407 Fallbrook Ave West Hills CA 91304
Rhode Island BLUE MEDICARERX
Blue Cross & Blue Shield of Rhode Island PDP
Clinical Pharmacist Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Rhode Island
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Rhode Island
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
Rhode IslandEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Rhode Island
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Rhode Island
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Rhode Island
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Rhode Island
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Rhode Island
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Rhode Island
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Rhode Island
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
Rhode IslandMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Rhode Island
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Rhode Island
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Rhode Island
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Rhode Island RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Rhode Island
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Rhode Island
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
MTMP Contacts, Updated 11/15/07 95
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Rhode Island
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Rhode Island
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Rhode Island
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Rhode Island
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Rhode Island
UNITED HEALTH PLANS OF NEW ENGLAND, INC.
UnitedHealthcare of New England, Inc. Local CCP
Vice President, Chief Medical Officer
Addiego, Jr. M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Rhode Island
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Rhode Island
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Rhode Island
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Rhode Island
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
South Carolina
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
South Carolina
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
South Carolina
ARCADIAN HEALTH PLAN OF GEORGIA, INC.
Southeast Community Care Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
South CarolinaARCADIAN HEALTH PLAN, INC.
Southeast Community Care Local CCP President Freeman Nancy
1-310-204-1101
1-510-817-1033
825 Washington Street, Suite 300 Oakland CA 94607
South Carolina
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA
Blue Cross Blue Shield of South Carolina Local CCP
Director - Provider Contracting Baughman Angie
1-803-264-3234
1-803-419-8020
I-20 at Alpine Road Columbia SC 29219
South Carolina
BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA
Blue Cross Blue Shield of South Carolina PDP
Director - Provider contracts Baughman Angie
1-803-264-3234
1-803-419-8020
2401 Faraway Drive Columbia SC 29223
South Carolina
BLUECHOICE HEALTHPLAN OF SOUTH CAROLINA, INC.
BlueChoice HealthPlan Local CCP McManus Lisa
1-803-382-5527
1-803-714-6463
[email protected] P.O. Box 6170 Columbia SC 29260
MTMP Contacts, Updated 11/15/07 96
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
South Carolina
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO
Care Improvement Plus Regional CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
South Carolina
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
South Carolina
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
South Carolina
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
South Carolina
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
South CarolinaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
South Carolina
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
South Carolina
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
South Carolina
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
South Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
South Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
South Carolina
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
South Carolina
INSTIL HEALTH INSURANCE COMPANY
InStil Health Insurance Company Regional CCP
Director Medical Services Lachuk Lester
1-803-763-6559
1-803-935-1605
17 Technology Circle Columbia SC 29203
South Carolina
INSTIL HEALTH INSURANCE COMPANY
InStil Health Insurance Company PDP
Director Medical Services Lachuk Lester
1-803-763-6559
1-803-935-1605
17 Technology Circle, AG-790 Columbia SC 29203
South Carolina
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
South CarolinaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
South Carolina
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
MTMP Contacts, Updated 11/15/07 97
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
South Carolina
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
South Carolina
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
South Carolina
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
South Carolina RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
South Carolina
SELECT HEALTH OF SOUTH CAROLINA, INC. PerformRx PDP
Supervisor, Pharmacy DUR/MTM Lawson Mark
1-215-937-5352
200 Stevens Drive 4th Floor Philadelphia PA 19113
South Carolina
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
South Carolina
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
South Carolina
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
South Carolina
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
South Carolina
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
South Carolina
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
South Carolina
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
South Carolina
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
South Carolina
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
South Carolina
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
South Carolina
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
South Carolina
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 98
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
South Dakota
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
South Dakota
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
South Dakota
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Wellmark Blue Cross Blue Shield of South Dakota Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
South Dakota
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Wellmark Blue Cross Blue Shield of South Dakota PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
South Dakota
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
South Dakota
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
South Dakota
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
South DakotaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
South Dakota
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
South Dakota
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
South DakotaFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
South Dakota
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
South Dakota
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
South Dakota
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
South Dakota
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
South Dakota
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
South Dakota
MEDICA INSURANCE COMPANY
Medica Insurance Company 1876 Cost Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
MTMP Contacts, Updated 11/15/07 99
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
South DakotaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
South Dakota
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
South Dakota
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
South Dakota
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
South Dakota RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
South Dakota
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
South Dakota
SOUTH DAKOTA STATE MEDICAL HOLDING COMPANY, INC. DAKOTACARE Local CCP
Director of Pharmacy Benefits Lounsbery Christine
1-866-437-3288 3150
[email protected] 2600 W 49th St Sioux Falls SD 57117
South Dakota
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
South Dakota
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
South Dakota
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
South Dakota
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
South Dakota
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
South Dakota
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
South Dakota
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
South Dakota
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
South Dakota
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Tennessee AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 100
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Tennessee
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Tennessee
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Tennessee
BCBS OF ALABAMA AND BCBS OF TENNESSEE
BlueCross BlueShield of Tennessee PDP
Clinical Pharmacy Admin Barry Lesley
1-334-213-6653
450 Riverchase Parkway East Birmingham AL 35244
Tennessee
BLUECROSS BLUESHIELD OF TENNESSEE
BlueCross BlueShield of Tennessee PFFS Colbaugh Janine
1-423-535-7023
[email protected] 801 Pine Street Chattanooga TN 37402
TennesseeCARITEN HEALTH PLAN IN Cariten Senior Health Local CCP
Pharmacy supervisor Feliciano Susan
1-865-670-7340
1420 Centerpoint Blvd Knoxville TN 37932
Tennessee
CARITEN INSURANCE COMPANY
Cariten Senior Health (PPO) Local CCP
Pharmacy Director Ciufo John
1-865-670-7382
1-865-670-7205
1420 Centerpoint Blvd Knoxville TN 37932
Tennessee
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Tennessee
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Tennessee
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Tennessee
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
TennesseeEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Tennessee
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Tennessee
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Tennessee
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
TennesseeHEALTHSPRING OF TENNESSEE, INC. Healthspring Local CCP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Tennessee
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Tennessee
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
MTMP Contacts, Updated 11/15/07 101
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Tennessee
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Tennessee
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Tennessee
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
TennesseeMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Tennessee
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Tennessee
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Tennessee
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Tennessee
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Tennessee RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Tennessee
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Tennessee
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Tennessee
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Tennessee
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Tennessee
UAHC HEALTH PLAN OF TENNESSEE, INC. UAHC Gold Plus Local CCP
Pharmacy, Clinical Services Director Hettich Lisa
1-765-526-2515
8407 Fallbrook Avenue
Well Point NextRx West Hills CA 91304
Tennessee
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Tennessee
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Tennessee
UNISON HEALTH PLAN OF TENNESSEE, INC. Unison Advantage Local CCP Brekosky Robert
1-412-349-6167
1-412-457-1616
[email protected] Unison Plaza
1001 Brinton Road Pittsburgh PA 15221
Tennessee
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
MTMP Contacts, Updated 11/15/07 102
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Tennessee
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Tennessee
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Tennessee
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Tennessee
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Tennessee
UNITED HEALTHCARE OF TENNESSEE, INC. SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main St.
Mail Stop: CA134-0404 Irvine CA 92614
Tennessee
UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.
UnitedHealthcare Plan of the River Valley, Inc. Local CCP
Prescriptions Solutions Graham Phyllis
1-972-866-1501
1-972-866-1911
5001 LBJ Fwy, Suite 600 Dallas TX 75244
Tennessee
UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.
UnitedHealthcare Plan of the River Valley, Inc. Local CCP
AmeriChoice Pharmacy Medical Management Hatch Vanessa L
1-703-226-3126
1-703-506-3536
8045 Leesburg Pike Ste. 650 Vienna VA 22182
Tennessee
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Tennessee
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
TennesseeWINDSOR HEALTH PLAN, INC Windsor Rx PDP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
TennesseeWINDSOR HEALTH PLAN, INC.
Windsor Medicare Extra PFFS
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
TennesseeWINDSOR HEALTH PLANS, INC.
Windsor Medicare Extra Local CCP
Pharmacy Director King Sonya
1-615-782-7860
1-615-782-7822
7100 Commerce Way, Ste 285 Brentwood TN 37027
Texas AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Texas
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Texas
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
MTMP Contacts, Updated 11/15/07 103
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Texas
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
TexasAMERIGROUP TEXAS, INC.
AMERIGROUP Community Care Local CCP
AVP Clincal Pharmacy Radzin Richard
1-757-518-3152
4425 Corporation Lane, #300 Virginia Beach, VA 23462
TexasARCADIAN HEALTH PLAN, INC.
Texas Community Care Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
TexasARKANSAS COMMUNITY CARE
Arkansas Community Care, Inc. Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court., Second Floor San Dimas CA 91773
TexasBRAVO HEALTH TEXAS, INC. Bravo by Elder Health Local CCP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
TexasBRAVO HEALTH TEXAS, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
Texas
CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY
Care Improvement Plus Regional CCP Moyna Audrey
1-847-559-3999
1-847-559-4733
2211 Sanders Road Northbrook IL 60062
Texas
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Texas
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Texas
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Texas
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
TexasEVERCARE OF TEXAS, LLC
Evercare Of Texas, LLC Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
TexasEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Texas
FIDELIS SECURECARE OF TEXAS, INC.
Fidelis SecureCare of Texas, Inc. Local CCP
Chief Medical Officer Sarran Scott
1-877-372-6203
1-847-517-1085
1700 East Golf Road Suite 1115 Schaumburg IL 60173
Texas
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Texas
HCSC INSURANCE SERVICES COMPANY
HISC - Blue Cross Blue Shield of Texas Local CCP
Pharmacy Director, Government Programs Nguyen Marie
1-651-286-4206
1-651-286-4403
Prime Therapeutics
1020 Discovery Road, No. 100 Egan MN 55121
Texas
HCSC INSURANCE SERVICES COMPANY
HISC - Blue Cross Blue Shield of Texas PDP
Pharmacy Director Nguyen Marie
1-651-286-4206
1-651-286-4403
Prime Therapeutics, LLC
1020 Discovery Road Eagen MN 55121
MTMP Contacts, Updated 11/15/07 104
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Texas
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Texas
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Texas
HUMANA HEALTH PLAN OF TEXAS,INC.
Humana Health Plan of Texas, Inc. Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Texas
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Texas
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Texas
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Texas
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Texas
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
TexasMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Texas
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Texas
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
TexasPACIFICARE OF TEXAS, INC.
Secure Horizons Medicare Advantage Plan Local CCP
VP, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Texas
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
TexasPSO HEALTH SERVICES, LLC
PHYSICIANS HEALTH CHOICE Local CCP
Vice President of Pharmacy - Envision Peterson Amanda
1-330-405-8080 263
2181 E. Aurora Rd. STE 201 Twinsburg OH 44087
Texas
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Texas RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
TexasSCOTT AND WHITE HEALTH PLAN
Scott and White Health Plan SeniorCare 1876 Cost PharmD Gabrillo Evelyn
1-254-298-6152
1-254-298-6189
4236 Lowes Drive Suite 100 Temple TX 76502
TexasSCOTT AND WHITE HEALTH PLAN Texas Rx Plan PDP
Patient Care Pharmacist Gabrillo Evelyn
1-254-298-6152
1-254-298-6189
4236 Lowes Drive Suite 100 Temple TX 76502
Texas
SELECTCARE HEALTH PLANS, INC.
TexasFirst Health Plans Local CCP
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
MTMP Contacts, Updated 11/15/07 105
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
TexasSELECTCARE OF TEXAS, L.L.C.
SelectCare of Texas, LLC Local CCP
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Texas SHA, L.L.C FirstCare Advantage Local CCP
Director of Pharmacy Services Crognale III Louis
1-512-257-6206
1-512-257-6016
12940 North Highway 183 Austin TX 78750
Texas
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Texas
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Texas
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Texas
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
TexasTEXAS HEALTHSPRING LLC Texas HealthSpring Local CCP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Texas
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Texas
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Texas
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Texas
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Texas
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main St
Mail Stop: CA134-0404 Irvine CA 92614
Texas
UNITED HEALTHCARE INSURANCE COMPANY
UNITED HEALTHCARE INSURANCE COMPANY Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Texas
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Texas
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
Texas
VALLEY BAPTIST INSURANCE COMPANY
Valley Baptist Health Plans Local CCP
Directory of Pharmacy Services Crognale III Louis
1-512-257-6206
1-512-257-6016
12940 N. Highway 183 Austin TX 78750
Texas
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
MTMP Contacts, Updated 11/15/07 106
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Texas
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Utah
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Utah
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Utah
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Utah
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Utah
EDUCATORS MUTUAL INSURANCE ASSOCIATION
Educators Mutual Insurance Association PDP Gallegos Jennifer
1-801-262-7476
852 East Arrowhead Lane Murray UT 84107
Utah
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
UtahEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Utah
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Utah
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Utah
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Utah
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Utah
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Utah
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Utah
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Utah
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
UtahMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MTMP Contacts, Updated 11/15/07 107
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Utah
MOLINA HEALTHCARE OF UTAH, INC.
Molina Healthcare of Utah Local CCP
Director, Pharmacy Schatzman Benjamin
1-562-951-1509 1509
1-562-437-9315
ONE GOLDEN SHORE DRIVE LONG BEACH CA 90802
Utah
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Utah
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Utah
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Utah
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Utah
REGENCE BLUECROSS BLUESHIELD OF UT
Regence BlueCross BlueShield of Utah Local CCP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 210
PO Box 2560 Boise ID 87301
Utah
REGENCE LIFE AND HEALTH INSURANCE COMPANY
Regence Life and Health PDP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 210
PO Box 2560 Boise ID 87301
Utah RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Utah
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. Sierra Spectrum Local CCP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Utah
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Utah
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Utah
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Utah
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Utah
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Utah
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Utah
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Utah
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
MTMP Contacts, Updated 11/15/07 108
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Utah
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Utah
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
UtahUNITEDHEALTHCARE OF UTAH, INC. SecureHorizons Local CCP Addiego Joseph
1-949-221-9994
[email protected] 2300 Main St
Mail Stop: CA134-0404 Irvine CA 92614
Utah
UNIVERSAL HEALTH CARE INSURANCE COMPANY
Universal Health Care Insurance Company, Inc. PFFS
Vice President Clinical Programs Schoening Shellie K
1-800-546-5677 1110
1-866-632-7946
[email protected] PO Box 407 Boys town NE 68010
Utah
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Utah
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Vermont
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Vermont
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Vermont
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Vermont BLUE MEDICARERXBlue Cross and Blue Shield of Vermont PDP
Clinical Pharmacist Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Vermont
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Vermont
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
VermontEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Vermont
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Vermont
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Vermont
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
MTMP Contacts, Updated 11/15/07 109
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Vermont
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Vermont
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Vermont
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Vermont
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
VermontMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Vermont
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Vermont
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Vermont
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Vermont RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Vermont
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Vermont
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Vermont
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Vermont
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Vermont
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Vermont
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Vermont
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Vermont
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Vermont
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 110
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Virgin Islands
MCS LIFE INSURANCE COMPANY MCS Classicare PFFS
Research Academic Pharmacist Santiago Edgardo
1-787-758-2500 4907
1-787-622-7766
[email protected] PO Box 191720 San Juan PR
00919-1720
Virgin IslandsMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Virgin Islands
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Virginia AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Virginia
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Virginia
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Virginia
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Virginia
ANTHEM HEALTH PLANS OF VIRGINIA, INC.
Anthem Blue Cross and Blue Shield Local CCP Hettich Lisa
1-765-526-2515
8407 Fallbrook Avenue West Hills CA 91304
Virginia
ANTHEM INSURANCE COMPANIES, INC.
Anthem Blue Cross and Blue Shield PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
Virginia
ANTHEM INSURANCE COMPANIES, INC.
Anthem Insurance Companies, Inc. PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Virginia
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Virginia
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Virginia
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Virginia
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
VirginiaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Virginia
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
MTMP Contacts, Updated 11/15/07 111
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Virginia
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Virginia
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Virginia
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Virginia
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Virginia
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Virginia
KAISER FNDN HP OF THE MID-ATLANTIC STS
Kaiser Permanente Medicare Plus 1876 Cost
Pharmacy Director Downard Susan
1-301-816-6835
2101 East Jefferson St Rockville MD 20852
Virginia
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
VirginiaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Virginia
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Virginia
OPTIMA HEALTH INSURANCE COMPANY
Optima Medicare Preferred Local CCP
Clinical Pharmacist Brusig Elizabeth
1-757-552-7519
1-757-552-7516
4417 Corporation Lane Virginia Beach VA 23462
Virginia
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Virginia
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Virginia
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Virginia RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Virginia
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Virginia
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Virginia
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Virginia
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Virginia
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
MTMP Contacts, Updated 11/15/07 112
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Virginia
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Virginia
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Virginia
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Virginia
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Virginia
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St.
CA134-0404 Irvine CA 92614
Virginia
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Virginia
UNITED HEALTHCARE INSURANCE COMPANY
United HealthCare Insurance Company Demo
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Virginia
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Virginia
UNITED HEALTHCARE PLAN OF THE RIVER VALLEY, INC.
UnitedHealthcare Plan of the River Valley, Inc. Local CCP
Prescriptions Solutions Graham Phyllis
1-972-866-1501
1-972-866-1911
5001 LBJ Fwy, Suite 600 Dallas TX 75244
Virginia
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Virginia
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Washington
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Washington
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
WashingtonARCADIAN HEALTH PLAN
Spokane Community Care Local CCP
Vice President of Pharmacy Services Owens Glenda
1-909-971-6816
1-909-971-6866
955 Overland Court, Second Floor San Dimas CA 91773
Washington
ASURIS NORTHWEST HEALTH
Asuris Northwest Health Local CCP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 210
PO Box 2560 Boise ID 87301
MTMP Contacts, Updated 11/15/07 113
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Washington
ASURIS NORTHWEST HEALTH
Asuris Northwest Health PDP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle
PO Box 2560 Boise ID 87301
Washington
COMMUNITY HEALTH PLAN OF WASHINGTON
Community HealthFirst Medicare Advantage Plan Local CCP
Pharmacy Director Koh Rachel
1-206-613-8859
1-206-521-8834
[email protected] 720 Olive Way Suite 300 Seattle WA
98101-1830
Washington
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Washington
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Washington
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
WashingtonEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Washington
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Washington
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
WashingtonFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
WashingtonGROUP HEALTH COOPERATIVE
Group Health Cooperative Local CCP
Associate Director of Clinical Pharmacy Operations Reitz Shirley
1-206-901-4334 [email protected]
Group Health Cooperative
12400 E. Marginal Way South Seattle WA
98168-2559
Washington
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Washington
HEALTH NET LIFE INSURANCE COMPANY
Health Net Medicare Advantage Local CCP
Vice President, Operations - HNPS
White, Pharm. D. Virginia E
1-916-463-9603
10540 White Rock Rd., Ste 280
Mail Top: CA-175-02-02
Rancho Cordova CA 95670
Washington
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Washington
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Washington
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Washington
KAISER FOUNDATION HP OF THE N W
Kaiser Foundation Health Plan of the NW Local CCP
Pharmacy Benefit Manager Logan Steve
1-503-261-7980
5725 NE 138th Ave Portland OR 97230
Washington
KAISER FOUNDATION HP OF THE N W
Kaiser Foundation Health Plan of the NW Demo
Pharmacy Benefit Manager Logan Steve
1-503-261-7980
5725 NE 138th Ave Portland OR 97230
Washington
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
MTMP Contacts, Updated 11/15/07 114
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
WashingtonMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Washington
MOLINA HEALTHCARE OF WASHINGTON, INC.
Molina Healthcare of Washington, Inc. Local CCP
Director, Pharmacy SCHATZMAN BENJAMIN
1-562-951-1509
1-562-437-9315
ONE GOLDEN SHORE DRIVE LONG BEACH CA 90802
Washington
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
WashingtonODS HEALTH PLAN, INC. ODS Advantage Rx PDP
Vice President Medical Services Richardson Robin
1-503-243-4491
1-503-948-5557
601 SW Second Ave Portland OR 97204
Washington
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
WashingtonPACIFICARE OF WASHINGTON, INC.
Secure Horizons Medicare Advantage Plan Local CCP
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Washington
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
WashingtonPROVIDENCE HEALTH PLAN
Providence Health Plan Local CCP
PHARMACY DIRECTOR NOONAN HELEN M
1-503-574-5708
1-503-574-8646
[email protected] PO BOX 3125 PORTLAND OR
97208-3125
Washington
REGENCE BLUECROSS BLUESHIELD OF OR
Regence BlueCross BlueShield of Oregon Local CCP
Manager Clinical Pharmacy Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle Suite 210
PO Box 2560 Boise ID 87301
WashingtonREGENCE BLUESHIELD Regence BlueShield Local CCP
Clinical Pharmacist Consultant III Leonard Ruth J
1-208-395-7732
1-208-395-7744
1211 West Myrtle
PO Box 2560 Boise ID 97201
Washington RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Washington
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
Washington
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Washington
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Washington
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Washington
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Washington
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Washington
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
MTMP Contacts, Updated 11/15/07 115
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Washington
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Washington
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Washington
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Washington
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Washington
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Washington
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Washington
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Washington D.C. AETNA HEALTH INC. Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Washington D.C.
AETNA LIFE INSURANCE COMPANY Aetna Medicare Local CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Washington D.C.
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Washington D.C.
AETNA LIFE INSURANCE COMPANY Aetna Medicare Regional CCP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Washington D.C.
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Washington D.C.
BRAVO HEALTH MID-ATLANTIC INC. Bravo by Elder Health Local CCP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
Washington D.C.
BRAVO HEALTH MID-ATLANTIC INC. Bravo by Elder Health PFFS
Vice President, Pharmacy Services Owens Heather
1-410-864-4583
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
Washington D.C.
BRAVO HEALTH MID-ATLANTIC, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell St Baltimore MD 21224
MTMP Contacts, Updated 11/15/07 116
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Washington D.C.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Washington D.C.
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Washington D.C.
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Washington D.C.
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
Washington D.C.
EXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Washington D.C. FIRST CARE, INC.
Medi-CareFirst BlueCross BlueShield PDP
Director, Pharmacy Management Wong Winston
1-410-528-7897
1501 S. Clinton St 8th Floor Baltimore MD 21224
Washington D.C.
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Washington D.C.
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Washington D.C.
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Washington D.C.
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Washington D.C.
KAISER FNDN HP OF THE MID-ATLANTIC STS
Kaiser Permanente Medicare Plus 1876 Cost
Pharmacy Director Downard Susan
1-301-816-6835
2101 East Jefferson St Rockville MD 20852
Washington D.C.
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
Washington D.C.
MEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Washington D.C.
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Washington D.C.
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Washington D.C.
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Washington D.C. RXAMERICA, LLC RxAmerica PDP
Director of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
Washington D.C.
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
MTMP Contacts, Updated 11/15/07 117
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Washington D.C.
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Washington D.C.
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Washington D.C.
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Washington D.C.
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Washington D.C.
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Washington D.C.
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Washington D.C.
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Washington D.C.
UNITED HEALTHCARE INSURANCE COMPANY
United Healthcare Insurance Company Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
[email protected] 2300 Main St
CA134-0404 Irvine CA 92614
Washington D.C.
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Washington D.C.
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Washington D.C.
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
West Virginia
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
West Virginia
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
West Virginia
AMERICAN PROGRESSIVE LIFE/HLTH INS. Today's Option PFFS
Manager of Pharmacy Clinical Services
Thomas, R.Ph. Chelsea
1-866-245-5190
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
West Virginia
AVALON INSURANCE COMPANY
Avalon Insurance Company PDP
Pharmacy Manager Frost Lisa
1-717-703-8466
2500 Elmerton Avenue Harrisburg PA 17177
West Virginia
BRAVO HEALTH INSURANCE COMPANY, INC. Bravo by Elder Health PDP
Clinical Pharmacist Owens Heather
1-800-625-9432
1-866-464-0709
3601 O'Donnell Street Baltimore MD 21224
MTMP Contacts, Updated 11/15/07 118
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
West Virginia
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
West Virginia
COVENTRY HEALTH AND LIFE INS. COMPANY
Carelink Advantra PPO Local CCP Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
West Virginia
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
West Virginia
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
West Virginia
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
West VirginiaEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
West Virginia
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
West Virginia
GEISINGER INDEMNITY INSURANCE COMPANY
Geisinger Health Plan Gold Rx PDP
Clinical Pharmacist Collins Vanessa
1-570-214-9606
1-570-271-5268
100 North Academy Avenue Danville PA
17822-3245
West Virginia
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
West Virginia
HEALTH PLAN OF THE UPPER OHIO VALLEY The Health Plan Local CCP
Director pharmacy services neal steve
1-740-695-7638
1-740-695-7925
[email protected] The Health Plan
52160 National Road East St. Clairsville OH 43950
West Virginia
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
West Virginia
HIGHMARK HEALTH INSURANCE COMPANY
Mountain State Blue Cross Blue Shield Local CCP
Manager -- Clinical Services Culley Eric
1-412-544-4005
1-412-544-7546
120 Fifth Avenue Place Suite 1812 Pittsburgh PA
15222-3099
West VirginiaHIGHMARK SENIOR RESOURCES INC.
Highmark Senior Resources Inc. PDP
Manager, Clinical Pharmacy Services Culley Eric
1-412-544-4005
1-412-544-4092
120 Fifth Avenue Ste. 1812 Pittsburgh PA 15222
West Virginia
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
West Virginia
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
West Virginia
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
West Virginia
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
West VirginiaMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
MTMP Contacts, Updated 11/15/07 119
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
West Virginia
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
West Virginia
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
West Virginia
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
West Virginia
QCC INS CO D/B/A AMERIHEALTH INS CO
AmeriHealth Advantage PDP
Supervisor, Pharmacy DUR/MTM Lawson Mark
1-215-937-5352
200 Stevens Drive 4th Floor Philadelphia PA 19113
West Virginia
QCC INS CO D/B/A AMERIHEALTH INS CO AmeriHealth Rx PDP
Senior Clinical Pharmacist DaCosta Maribel
1-215-241-7928
1901 Market Street 22nd Floor Philadelphia PA 19103
West Virginia RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
West Virginia
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. SierraRx PDP
Director, Pharmacy Services Evans, M.D. Steven
1-702-877-8377
2716 N. Tenaya Way Las Vegas NV 89128
West Virginia
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
West Virginia
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
West Virginia
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
West Virginia
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
West Virginia
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
West Virginia
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
West Virginia
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
West Virginia
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
West VirginiaUPMC HEALTH BENEFITS, INC UPMC Health Plan PDP
Manager, Medicare Operations Cain John
1-412-454-5539
112 Washington Place Pittsburgh PA 15219
West Virginia
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
West Virginia
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 120
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
WisconsinABRI HEALTH PLAN, INC Today's Health Local CCP
Manager of Pharmacy Clinical Services Thomas R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Wisconsin
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Wisconsin
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Wisconsin
ANTHEM INSURANCE COMPANIES, INC.
Anthem Insurance Companies, Inc. PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mailstop CAAF West Hills CA 91304
Wisconsin
ANTHEM INSURANCE COMPANIES, INC.
Blue Cross Blue Shield of Wisconsin PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mailstop OH2104-A844 Mason OH 45040
WisconsinCARE WISCONSIN HEALTH PLAN, INC.
Elder Care Health Plan, Inc Local CCP Pharmacist Hetzel Jean
1-608-245-3037
1-608-245-3077
2802 International Lane Madison WI 53704
WisconsinCARE WISCONSIN HEALTH PLAN, INC.
Elder Care Health Plan, Inc. Demo Pharmacist Hetzel Jean
1-608-245-3037
1-608-245-3077
2802 International Lane Madison WI 53704
WisconsinCOMMUNITY CARE HEALTH PLAN, INC Community Care Demo
Clinical Pharmacist Supervisor Mueller Richard J
1-414-902-2397
1-414-274-8490
1555 S. Layton Blvd. Milwaukee WI 53215
Wisconsin
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Wisconsin
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Wisconsin
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
WisconsinDEAN HEALTH INSURANCE, INC.
Dean Health Insurance, Inc. PDP Staresnic Anthony
1-608-827-7513
999 Fourier Drive, Suite 301 Madison WI 53717
Wisconsin
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
WisconsinEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Wisconsin
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Wisconsin
GROUP HEALTH COOPERATIVE OF EAU CLAIRE
Wisconsin Personal Care Plan Local CCP Medical Director Blaser Lon
1-715-852-2080
1-715-836-7683
[email protected] P.O. Box 3217 Eau Claire WI
54702-3217
Wisconsin
GUNDERSEN LUTHERAN HEALTH PLAN
Gundersen Lutheran Health Plan, Inc. Local CCP
Pharmacy Director Schuth Grant C
1-608-775-8059 58059
1-608-775-8790
1900 South Avenue
Mail Stop NCA2-01 La Crosse WI 54601
MTMP Contacts, Updated 11/15/07 121
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Wisconsin
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Wisconsin
HEALTH PLAN FOR COMMUNITY LIVING, INC.
Health Plan for Community Living Demo Pharmacist Schea-Holmes Lani M
1-608-242-8335 2190
1-608-240-7060
1414 MacArthur Road
PO Box 8028 Madison WI
53708-8028
Wisconsin
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Wisconsin
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Wisconsin
HUMANA INSURANCE COMPANY
Humana Insurance Company Local CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Wisconsin
HUMANA INSURANCE COMPANY
Humana Insurance Company Regional CCP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Wisconsin
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Wisconsin
INDEPENDENT CARE HEALTH PLAN, INC. iCare Local CCP Tirado Breanne
1-414-231-1087
1-414-231-1075
1555 N Rivercenter Drive Suite 202A Milwaukee WI 53211
Wisconsin
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
Wisconsin
MEDICA HEALTH PLAN S OF WISCONSIN
Medica Health Plans of Wisconsin PFFS Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
Wisconsin
MEDICA INSURANCE COMPANY
Medica Insurance Company 1876 Cost Weiss Justin
1-952-992-2469
401 Carlson Parkway Minnetonka MN 55305
WisconsinMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Wisconsin
NETWORK HEALTH INSURANCE CORPORATION Network PlatinumPlus Local CCP
Pharmacy Director Rynearson Chuck
1-920-720-1603
1570 Midway Place
P.O. Box 120 Menasha WI 54952
Wisconsin
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Wisconsin
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
WisconsinPARTNERSHIP HEALTH PLAN, INC.
Community Health Partnership Demo Pharmacist Maslonkowski Chris
1-715-858-7008
2240 EastRidge Center Eau Claire WI 54701
Wisconsin
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
Wisconsin
PYRAMID LIFE INSURANCE COMPANY Today's Option PFFS
Manager of Pharmacy Clinical Services Thomas, R.Ph Chelsea
1-713-770-1265
1-866-553-0396
4888 Loop Central Drive Suite 800 Houston TX 77081
Wisconsin RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
MTMP Contacts, Updated 11/15/07 122
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Wisconsin
SECURITY HEALTH PLAN OF WISCONSIN, INC
Security Health Plan Of Wisconsin, Inc Local CCP
Clinical Pharmacy Specialist Proudfit Jennifer
1-715-221-9920
1-715-221-9989
1515 Saint Joseph Avenue Marshfield WI 54449
Wisconsin
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Wisconsin
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Wisconsin
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Wisconsin
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Wisconsin
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Wisconsin
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Wisconsin
UNITED HEALTHCARE INSURANCE COMPANY SecureHorizons PFFS Addiego Joseph
1-949-221-9994
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Wisconsin
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Wisconsin
UNITED HEALTHCARE OF WISCONSIN, INC SecureHorizons Local CCP
Vice President, Chief Medical Officer
Addiego, Jr., M.D. Joseph E
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop CA134-0404 Irvine CA 92614
Wisconsin
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Ren 2 Tampa FL 33634
Wisconsin
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
Wisconsin
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION
WPS Health Insurance PDP
Director Pharmacy Benefits Armstrong David
1-608-226-7883
1717 West Broadway
PO Box 8190 Madison WI 53708
Wyoming
AETNA LIFE INSURANCE COMPANY Aetna Medicare PFFS
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2453
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Wyoming
AETNA LIFE INSURANCE COMPANY Aetna Medicare PDP
Director, Medicare Clinical Pharmacy Programs Stern Jody L
1-386-963-2543
1-860-754-1481
5350 148th Place Wellborn FL
32094-2362
Wyoming
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross Blue Shield of Wyoming Regional CCP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross and Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
MTMP Contacts, Updated 11/15/07 123
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Wyoming
BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE
Blue Cross Blue Shield of Wyoming PDP
Director of Pharmacy Heaton Alan
1-651-662-8758
1-651-662-6009
Blue Cross Blue Shield of Minnesota
3400 Yankee Drive Eagan MN 55122
Wyoming
CONNECTICUT GENERAL LIFE INSURANCE COMPANY CIGNATURE Rx PDP Zheng Yi
1-860-226-6731
900 Cottage Grove Road B5PHR Bloomfield CT 06002
Wyoming
COVENTRY HEALTH AND LIFE INSURANCE COMPANY Advantra® Freedom PFFS Stephens Debbie
1-804-965-7658
Coventry Health Care, Inc
4300 Cox Road Glen Allen VA 23060
Wyoming
ENVISION INSURANCE COMPANY EnvisionRx Plus PDP
Pharmacy Director Peterson Amanda
1-330-405-8080 6320
1-330-405-8081
2181 E Aurora Rd Suite 201 Twinsburg OH 44087
WyomingEXPRESS SCRIPTS INSURANCE CO. SAMAscript PDP Hirsch Jeff
1-314-810-6102
One Express Way St. Louis MO 63121
Wyoming
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Coventry AdvantraRx PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
Wyoming
FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY First Health Part D PDP
Director, Quality Improvement Stephens Debbie
1-804-965-7658
[email protected] 4300 Cox Road Glen Allen VA 23060
WyomingFOX INSURANCE COMPANY
FOX Insurance Company PDP VP, Pharmacy Arloro Anthony
1-877-369-9564 113
40 West 25th Street 6th Floor New York NY 10010
Wyoming
HEALTH NET LIFE INS CO/HEALTH NET INS OF NY Health Net PDP
Director, Clinical Pharmacy Services
Misquitta, Pharm. D. Cathrine V
1-916-463-9603
1-916-463-9750
10540 White Rock Rd.., Ste. 280
Mail Stop: CA-175-02-02
Rancho Cordova CA 95670
Wyoming
HEALTHSPRING INC. HEALTHSPRING OF ALABAMA, INC.
HealthSpring Prescription Drug Plan PDP
Director, Government Programs Christopher Kelly
1-615-565-8110
1-615-234-2154
601 Mainstream Drive Nashville TN 37228
Wyoming
HUMANA INSURANCE COMPANY
Humana Insurance Company PFFS Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Wyoming
HUMANA INSURANCE COMPANY
Humana Insurance Company PDP Ewing Joy
1-502-580-3538
500 West Main Street Louisville KY 40202
Wyoming
MEDCO CONTAINMENT LIFE INSURANCE COMPANY Medco YOURx PLAN PDP
Chief Medical Officer
Eisenberg, MD Edward
1-201-269-6717
1-201-269-1008
100 Parsons Pond Drive E2-7 Franklin Lakes NJ 07417
WyomingMEMBERHEALTH, INC. MEMBERHEALTH PDP
VP Clinical Operations Rajan Samuel
1-440-248-8448 135
1-440-248-1729
29100 Aurora Rd., Ste. 301 Solon OH 44139
Wyoming
NMHC GROUP SOLUTION INSURANCE, INC.
NMHC Group Solutions PDP
DIRECTOR, CLINICAL MEDICARE SERVICES MARKS INY R
1-516-605-6966
1-412-322-2066
600 WATERFRONT DR. STE 225 PITTSBURGH PA 15222
Wyoming
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
SecureHorizons MedicareDirect PFFS
Vice President, Chief Medical Officer Addiego Joseph
1-949-221-9994
1-949-474-4237
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Wyoming
PENNSYLVANIA LIFE INSURANCE COMPANY
Pennsylvania Life Insurance Company PDP
Medicare Clinical Pharmacist Brown Nancy J
1-401-333-3987 7941
1-800-373-0238
695 George Washington Highway Lincoln RI 02865
WyomingROCKY MOUNTAIN HEALTH PLANS
Rocky Mountain Health Plans 1876 Cost
Pharmacy Director Nolan Steve
1-970-244-7760 5182
[email protected] PO Box 10600 Grand Junction CO 81502
Wyoming RXAMERICA, LLC RxAmerica PDPDirector of PDP Operations Low Jeff
1-801-961-6251
221 N. Charles Lindbergh Dr. SLC UT 84116
MTMP Contacts, Updated 11/15/07 124
STATELEGAL ENTITY
NAME ORGANIZATION
NAMEORGANIZATION DESCRIPTION TITLE LAST NAME FIRST NAME MI PHONE
PHONE EXT FAX EMAIL
STREET ADDRESS
STREET ADDRESS
2 CITY STATE ZIP
Wyoming
SILVERSCRIPT INSURANCE COMPANY SilverScript PDP Help Desk MTM
1-866-443-0934
9501 E. Shea Blvd Scottsdale AZ 85260
Wyoming
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PFFS
V.P. Compliance & Regulatory Affairs Bodway Craig
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Wyoming
STERLING LIFE INSURANCE COMPANY
Sterling Life Insurance Company PDP
VP Compliance & Regulatory Affairs Bodway Craig A
1-360-647-9080 29098
1-360-647-8632
2219 Rimland Drive
PO Box 5348 Bellingham WA
98227-5348
Wyoming
UNICARE LIFE AND HEALTH INS. COMPANY
Unicare Life & Health Ins. Company PFFS Client Manager Drummond Michelle
1-714-637-1282
1-714-637-1209
8407 Fallbrook Avenue
Mail Stop CAAF West Hills CA 91304
Wyoming
UNICARE LIFE AND HEALTH INSURANCE COMPANY Unicare PDP
Pharmacist Clinical Hettich Lisa
1-765-526-2515
8990 Duke Drive
Mail Stop OH2104-A844 Mason OH 45040
Wyoming
UNITED AMERICAN INSURANCE COMPANY
United American Insurance Company PDP
Vice President and Health Actuary Hendee Peter G
1-972-569-3646
1-972-569-3679
3700 S. Stonebridge Drive McKinney TX 75070
Wyoming
UNITED HEALTH CARE INS. CO. AND UNITED NEW YORK UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA134-0404 Irvine CA 92614
Wyoming
UNITED HEALTHCARE INSURANCE COMPANY UnitedHealthcare PDP Bowen Jo
1-949-252-4339
2300 Main Street
Mail Stop: CA1340404 Irvine CA 92614
Wyoming
WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WellCare PFFS
Director Medication Therapy Management Delancy Lisa
1-813-290-6200 3768
8735 Henderson Rd Tampa FL 33634
Wyoming
WELLCARE PRESCRIPTION INSURANCE, INC. WellCare PDP
Director Clinical Pharmacy Delancey Lisa
1-813-290-6200 3768
8735 Henderson Road, Ren 2 Tampa FL 33634
MTMP Contacts, Updated 11/15/07 125