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SINA DRUG, LLC D/B/A ONCO360
DSH050009 ST Joseph Health Northern California LLC-DBA Queen of the Valley Medical Center
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Covered Entity Details
Entity Name
ST Joseph Health Northern California LLC-DBA Queen of the Valley Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050009
Entity Address
1000 TRANCAS STREET
NAPA, CA 94558
Medicare Provider Number
050009
Participating Start Date
4/1/2016
Last Recertification Date
8/16/2024
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
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brandon Williams, CFO, Queen of the Valley Medical Center
(707) 387-1872
Contract Pharmacy Representative
Onco360 Oncology Pharmacy
Jim Bozora, VP of 340B Oncology Sales
(702) 281-5985
Signed By Date
4/15/2024
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