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SINA DRUG LLC
DSH100007 AdventHealth Orlando
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Covered Entity Details
Entity Name
AdventHealth Orlando
Subdivision Name
Florida Hospital Orlando
Type
Disproportionate Share Hospital
340B ID
DSH100007
Entity Address
601 E. Rollins St.
Orlando, FL 32803-1248
Medicare Provider Number
100007
Participating Start Date
4/1/2012
Last Recertification Date
8/29/2024
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
7/10/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
7/10/2024
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