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SINA DRUG LLC
DSH230207 McLaren Oakland
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Covered Entity Details
Entity Name
McLaren Oakland
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230207
Entity Address
50 NORTH PERRY
PONTIAC, MI 48342
Medicare Provider Number
230207
Participating Start Date
1/1/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
SINA DRUG LLC
Pharmacy Address
DBA ONCO360
1985 MARCUS AVE STE 120
NEW HYDE PARK, NY 11042
Pharmacy Comments
08/02/2012 corrected name (was OncoMed Pharmacy)
Contract Details
Approval Date
10/20/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/4/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lynn Marcotte, CFO
(248) 338-5691
Contract Pharmacy Representative
Onco360
Eddie Shadeed, Hospital Account Manager
(205) 447-0530
Signed By Date
10/20/2021
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