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ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
DSH060054 COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060054
Entity Address
2351 G ROAD
GRAND JUNCTION, CO 81505
Medicare Provider Number
060054
Participating Start Date
4/1/2021
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
Pharmacy Address
D/B/A ONCO360
140 JOHN JAMES AUDUBON PKWY STE 101
AMHERST, NY 14228
Pharmacy Comments
Contract Details
Approval Date
6/16/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christian A. Thomas, CEO
(970) 644-3011
Contract Pharmacy Representative
Onco360
Eric Smith, Director of Pharmacy
(877) 662-6633 Ext: 1602
Signed By Date
6/16/2021
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