Contract Pharmacy Details

SINA DRUG LLC
DSH140067 SAINT FRANCIS MEDICAL CENTER

Covered Entity Details

Entity Name

SAINT FRANCIS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH140067

Entity Address

530 NE GLEN OAK AVENUE
PEORIA, IL 61637

Medicare Provider Number

140067

Participating Start Date

10/1/2006

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

SINA DRUG LLC

Pharmacy Address

DBA ONCO360
1985 MARCUS AVE STE 120
NEW HYDE PARK, NY 11042

Pharmacy Comments

08/02/2012 corrected name (was OncoMed Pharmacy)

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/6/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Diane L. McGrew, President
(309) 655-2850

Contract Pharmacy Representative

Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203

Signed By Date

7/15/2020

340B Drug Pricing Program Database