Contract Pharmacy Details

SINA DRUG LLC
DSH370093 OU MEDICAL CENTER

Covered Entity Details

Entity Name

OU MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH370093

Entity Address

700 NE 13TH ST.
OKLAHOMA CITY, OK 73104

Medicare Provider Number

370093

Participating Start Date

7/1/2018

Last Recertification Date

9/4/2024

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

4/17/2023

Contract Begin Date

5/3/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Krystal L Murer, Vice President | Ethics, Regulatory Affairs, and Chief Compliance Officer
(405) 271-8052

Contract Pharmacy Representative

Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203

Signed By Date

4/17/2023

340B Drug Pricing Program Database