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ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
DSH470003 UNIVERSITY OF VERMONT MEDICAL CENTER
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Covered Entity Details
Entity Name
UNIVERSITY OF VERMONT MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH470003
Entity Address
111 Colchester Avenue
Burlington, VT 05401
Medicare Provider Number
470003
Participating Start Date
4/1/2005
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
Pharmacy Address
D/B/A ONCO360
140 JOHN JAMES AUDUBON PKWY STE 101
AMHERST, NY 14228
Pharmacy Comments
Contract Details
Approval Date
10/17/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christina Oliver, VP of Clinical Services
(802) 847-2805
Contract Pharmacy Representative
Onco360
Eric Smith, Director of Pharmacy
(877) 662-6633 Ext: 1602
Signed By Date
10/17/2018
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