Contract Pharmacy Details

SORKIN'S RX LTD
SCH330307-00 CAYUGA MEDICAL CENTER AT ITHACA

Covered Entity Details

Entity Name

CAYUGA MEDICAL CENTER AT ITHACA

Subdivision Name

Type

Sole Community Hospital

340B ID

SCH330307-00

Entity Address

101 DATES DRIVE
ITHACA, NY 14850

Medicare Provider Number

330307

Participating Start Date

10/1/2018

Last Recertification Date

Entity Termination Date

7/1/2019

Pharmacy Details

Pharmacy Name

SORKIN'S RX LTD

Pharmacy Address

D/B/A CAREMED PHARMACEUTICAL SERVICES
1985 MARCUS AVE STE 130
NEW HYDE PARK, NY 11042-2024

Pharmacy Comments

Contract Details

Approval Date

8/1/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/21/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

John Collett, CHIEF FINANCIAL OFFICER
(607) 274-4441

Contract Pharmacy Representative

SORKIN'S RX LTD
Bincy Varghese, Director of Pharmacy
(877) 227-3405 Ext: 9013

Signed By Date

7/2/2018

340B Drug Pricing Program Database