Contract Pharmacy Details

ONCO360
DSH260137B FREEMAN HEALTH SYSTEM

Covered Entity Details

Entity Name

FREEMAN HEALTH SYSTEM

Subdivision Name

CORNELL-BESHORE CANCER INSTITUTE

Type

Disproportionate Share Hospital

340B ID

DSH260137B

Entity Address

3415 MCINTOSH CIR
JOPLIN, MO 64804-3651

Medicare Provider Number

260137

Outpatient Facility Provider Number

Participating Start Date

4/1/2004

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

ONCO360

Pharmacy Address

4041 HADLEY ROAD
SOUTH PLAINFIELD, NJ 07080

Pharmacy Comments

Contract Details

Approval Date

10/14/2014

Contract Begin Date

1/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/16/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

STEVE GRADDY, CFO
(417) 347-6678

Contract Pharmacy Representative

Burt Zweigenhaft, CEO
(646) 356-7709

Signed By Date

10/14/2014