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SINA DRUG LLC
DSH230020 Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital
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Covered Entity Details
Entity Name
Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230020
Entity Address
18101 OAKWOOD BOULEVARD
DEARBORN, MI 48124
Medicare Provider Number
230020
Participating Start Date
7/1/2006
Last Recertification Date
9/6/2024
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
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Ann Susick, COO
(947) 522-3349
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
7/14/2023
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