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SORKIN'S RX LTD
DSH500053 KENNEWICK GENERAL HOSPITAL
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Covered Entity Details
Entity Name
KENNEWICK GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500053
Entity Address
900 S AUBURN STREET
KENNEWICK, WA 99336
Medicare Provider Number
500053
Participating Start Date
10/1/2004
Last Recertification Date
12/6/2017
Entity Termination Date
10/1/2018
Pharmacy Details
Pharmacy Name
SORKIN'S RX LTD
Pharmacy Address
D/B/A CAREMED PHARMACEUTICAL SERVICES
1985 MARCUS AVE STE 130
NEW HYDE PARK, NY 11042-2024
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tony Sudduth, CFO
(509) 221-5349
Contract Pharmacy Representative
Caremed
Jim Bozora, Vice President, 340B Oncology Services
(702) 281-5985
Signed By Date
1/15/2018
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