Contract Pharmacy Details

SORKIN'S RX LTD
DSH150004 FRANCISCAN HEALTH HAMMOND

Covered Entity Details

Entity Name

FRANCISCAN HEALTH HAMMOND

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH150004

Entity Address

5454 HOHMAN AVE
HAMMOND, IN 46320

Medicare Provider Number

150004

Participating Start Date

4/1/2013

Last Recertification Date

8/31/2022

Entity Termination Date

1/1/2023

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

10/12/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

JOSEPH MARC GOLAN, CFO - NWI
(219) 932-2300 Ext: 34107

Contract Pharmacy Representative

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

Signed By Date

10/12/2018

340B Drug Pricing Program Database