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ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
DSH390002 UPMC MCKEESPORT
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Covered Entity Details
Entity Name
UPMC MCKEESPORT
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390002
Entity Address
1500 FIFTH AVENUE
MCKEESPORT, PA 15132
Medicare Provider Number
390002
Participating Start Date
4/1/2012
Last Recertification Date
8/28/2024
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
10/11/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/7/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Laurene Timmons, CFO
(412) 664-6781
Contract Pharmacy Representative
Onco360
Eric Smith, Director of Pharmacy
(877) 662-6633 Ext: 1602
Signed By Date
10/11/2021
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