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SINA DRUG LLC
DSH390133 LEHIGH VALLEY
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Covered Entity Details
Entity Name
LEHIGH VALLEY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390133
Entity Address
1200 South Cedar Crest Boulevard
ALLENTOWN, PA 18103-4000
Medicare Provider Number
390133
Participating Start Date
1/1/2023
Last Recertification Date
8/30/2024
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
1/6/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
1/6/2023
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