Contract Pharmacy Details

SINA DRUG LLC
DSH010129 GULF HEALTH HOSPITALS, INC. DBA NORTH BALDWIN INFIRMARY

Covered Entity Details

Entity Name

GULF HEALTH HOSPITALS, INC. DBA NORTH BALDWIN INFIRMARY

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH010129

Entity Address

1815 HAND AVE.
BAY MINETTE, AL 36507

Medicare Provider Number

010129

Participating Start Date

7/1/2005

Last Recertification Date

8/12/2024

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

4/14/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kenny H Breal, President
(251) 648-7673

Contract Pharmacy Representative

Onco360
Christopher Choi, Director of Pharmacy
(877) 662-6633 Ext: 1203

Signed By Date

4/14/2025

340B Drug Pricing Program Database