Contract Pharmacy Details

SORKIN'S RX LTD
RRC140064-00 ST. MARY MEDICAL CENTER

Covered Entity Details

Entity Name

ST. MARY MEDICAL CENTER

Subdivision Name

Type

Rural Referral Center

340B ID

RRC140064-00

Entity Address

3333 N SEMINARY
GALESBURG, IL 61401

Medicare Provider Number

140064

Participating Start Date

7/1/2018

Last Recertification Date

8/26/2021

Entity Termination Date

7/1/2022

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

7/1/2022
Covered Entity Terminated

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

340B Drug Pricing Program Database