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SINA DRUG LLC
DSH100034 MOUNT SINAI MEDICAL CENTER
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Covered Entity Details
Entity Name
MOUNT SINAI MEDICAL CENTER
Subdivision Name
MOUNT SINAI MEDICAL CENTER OF FLORIDA INC.
Type
Disproportionate Share Hospital
340B ID
DSH100034
Entity Address
4300 Alton Road
MIAMI BEACH, FL 33140
Medicare Provider Number
100034
Participating Start Date
4/1/2007
Last Recertification Date
9/3/2024
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
1/17/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANGEL PALLIN, SVP OF OPERATIONS
(305) 674-2520
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
1/17/2024
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