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SORKIN'S RX LTD
DSH140113 OSF Heart of Mary Medical Center
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Covered Entity Details
Entity Name
OSF Heart of Mary Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140113
Entity Address
1400 WEST PARK STREET
URBANA, IL 61801
Medicare Provider Number
140113
Participating Start Date
10/1/2015
Last Recertification Date
9/3/2024
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
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
SORKIN'S RX LTD
Bincy Varghese, Director of Pharmacy
(877) 227-3405 Ext: 9013
Signed By Date
7/15/2020
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