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SINA DRUG, LLC D/B/A ONCO360
DSH030014 HONORHEALTH JOHN C. LINCOLN MED CTR
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Covered Entity Details
Entity Name
HONORHEALTH JOHN C. LINCOLN MED CTR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH030014
Entity Address
250 E Dunlap Ave
Phoenix, AZ 85020
Medicare Provider Number
030014
Participating Start Date
7/1/2015
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
SINA DRUG, LLC D/B/A ONCO360
Pharmacy Address
15990 N GREENWAY HAYDEN LOOP STE D-100
SCOTTSDALE, AZ 85260
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
lalit mansukhani, COO
(480) 324-7001
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
7/17/2023
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