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SINA DRUG LLC
DSH110001 HAMILTON MEDICAL CENTER INC.
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Covered Entity Details
Entity Name
HAMILTON MEDICAL CENTER INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH110001
Entity Address
1200 Memorial Dr
DALTON, GA 30720
Medicare Provider Number
110001
Participating Start Date
7/1/2005
Last Recertification Date
8/22/2024
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
Randall Foster, Vice President-Finance
(706) 272-6124 Ext: 6124
Contract Pharmacy Representative
Hamilton Medical Center
Gregory K. Stinnett, Director of Pharmacy
(706) 272-6020
Signed By Date
7/14/2023
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