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SINA DRUG LLC
DSH420049 CONWAY HOSPITAL
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Covered Entity Details
Entity Name
CONWAY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH420049
Entity Address
300 SINGLETON RIDGE ROAD
CONWAY, SC 29526
Medicare Provider Number
420049
Participating Start Date
7/1/2019
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
SINA DRUG LLC
Pharmacy Address
D/B/A ONCO 360
13410 EASTPOINT CENTRE DR
STE 101
LOUISVILLE, KY 40223
Pharmacy Comments
Contract Details
Approval Date
10/13/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bret Alan Barr, CEO
(843) 347-8114
Contract Pharmacy Representative
Onco360
Sara Hess, Director of Pharmacy
(877) 662-6633 Ext: 1706
Signed By Date
10/13/2020
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