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SINA DRUG LLC
DSH110078 EMORY UNIVERSITY HOSPITAL MIDTOWN
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Covered Entity Details
Entity Name
EMORY UNIVERSITY HOSPITAL MIDTOWN
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH110078
Entity Address
550 PEACHTREE STREET, NE
ATLANTA, GA 30308-2209
Medicare Provider Number
110078
Participating Start Date
4/1/2006
Last Recertification Date
9/5/2024
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
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ava E Daunt-Samford, CFO
(404) 686-4918
Contract Pharmacy Representative
Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203
Signed By Date
1/15/2025
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