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SORKIN'S RX LTD
DSH330104 MONTEFIORE NYACK HOSPITAL
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Covered Entity Details
Entity Name
MONTEFIORE NYACK HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330104
Entity Address
160 NORTH MIDLAND AVENUE
NYACK, NY 10960
Medicare Provider Number
330104
Participating Start Date
4/1/2006
Last Recertification Date
8/16/2024
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
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John S. Burke, CFO
(845) 348-2107
Contract Pharmacy Representative
Onco360 Oncology Pharmacy
Diana Roberti, Manager
(410) 940-8494
Signed By Date
1/10/2020
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