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ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO
DSH240038 United Hospital
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Covered Entity Details
Entity Name
United Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH240038
Entity Address
333 North Smith Ave
St Paul, MN 55102
Medicare Provider Number
240038
Participating Start Date
10/1/2013
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
10/7/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/3/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785
Contract Pharmacy Representative
Onco360
Eric Smith, Director of Pharmacy
(877) 662-6633 Ext: 1602
Signed By Date
10/7/2022
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