Contract Pharmacy Details

SINA DRUG LLC
DSH140217 PRESENCE SAINT JOSEPH HOSPITAL ELGIN

Covered Entity Details

Entity Name

PRESENCE SAINT JOSEPH HOSPITAL ELGIN

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH140217

Entity Address

77 NORTH AIRLITE ST.
ELGIN, IL 60123

Medicare Provider Number

140217

Participating Start Date

4/1/2021

Last Recertification Date

8/16/2024

Entity Termination Date

4/1/2025

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

4/5/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Kevin Larkin, Chief Financial Officer
(630) 801-2729

Contract Pharmacy Representative

Sina Drugs dba Onco 360 Illinois
Kimberely Beranek, Director of Pharmacy
(877) 662-6633 Ext: 2101

Signed By Date

4/5/2021

340B Drug Pricing Program Database