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SINA DRUG LLC
DSH050496 JOHN MUIR MEDICAL CENTER - CONCORD
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Covered Entity Details
Entity Name
JOHN MUIR MEDICAL CENTER - CONCORD
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050496
Entity Address
2540 EAST STREET
CONCORD, CA 94520
Medicare Provider Number
050496
Participating Start Date
1/1/2023
Last Recertification Date
8/18/2024
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
4/4/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Zach Harris, VP Ancillary Services
(808) 457-0157
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
4/4/2024
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