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ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
DSH330241 UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330241
Entity Address
750 East Adams Street
Syracuse, NY 13210
Medicare Provider Number
330241
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
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
10/12/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John McCabe, Chief Executive Officer
(315) 464-4223
Contract Pharmacy Representative
Onco360
Eric Smith, Director of Pharmacy
(877) 662-6633 Ext: 1602
Signed By Date
10/12/2016
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