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SINA DRUG LLC
DSH140052 OSF SAINT ANTHONY'S HEALTH CENTER
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Covered Entity Details
Entity Name
OSF SAINT ANTHONY'S HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140052
Entity Address
1 SAINT ANTHONYS WAY
ALTON, IL 62002
Medicare Provider Number
140052
Participating Start Date
3/15/2022
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
SINA DRUG LLC
Pharmacy Address
DBA ONCO360
7125 JANES AVE
STE 700
WOODRIDGE, IL 60517
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/7/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Diane L. McGrew, President
(309) 655-2850
Contract Pharmacy Representative
Sina Drugs dba Onco 360 Illinois
Kimberely Beranek, Director of Pharmacy
(877) 662-6633 Ext: 2101
Signed By Date
7/15/2020
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