Contract Pharmacy Details

SORKIN'S RX LTD
DSH440176 INDIAN PATH COMMUNITY HOSPITAL

Covered Entity Details

Entity Name

INDIAN PATH COMMUNITY HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH440176

Entity Address

2000 BROOKSIDE DRIVE
KINGSPORT, TN 37660-4627

Medicare Provider Number

440176

Participating Start Date

10/1/2015

Last Recertification Date

9/4/2024

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

7/17/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Shane Hilton, VP/CFO - Market Operations
(423) 302-3467

Contract Pharmacy Representative

CareMed Specialty Pharmacy
Salvatore Spatola, Inventory Manager
(877) 227-3405 Ext: 9031

Signed By Date

7/17/2018

340B Drug Pricing Program Database