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SINA DRUG LLC
DSH360051 MIAMI VALLEY HOSPITAL
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Covered Entity Details
Entity Name
MIAMI VALLEY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360051
Entity Address
ONE WYOMING STREET
DAYTON, OH 45409
Medicare Provider Number
360051
Participating Start Date
4/1/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
SINA DRUG LLC
Pharmacy Address
DBA ONCO360
7125 JANES AVE
STE 700
WOODRIDGE, IL 60517
Pharmacy Comments
Contract Details
Approval Date
4/5/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Craig Allen Ganger, Chief Financial Officer
(937) 499-9988
Contract Pharmacy Representative
Sina Drugs dba Onco 360 Illinois
Kimberely Beranek, Director of Pharmacy
(877) 662-6633 Ext: 2101
Signed By Date
4/5/2024
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