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SORKIN'S RX LTD
DSH230015 THREE RIVERS HEALTH
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Covered Entity Details
Entity Name
THREE RIVERS HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230015
Entity Address
701 S. HEALTH PARKWAY
THREE RIVERS, MI 49093
Medicare Provider Number
230015
Participating Start Date
10/1/2011
Last Recertification Date
8/28/2024
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
4/5/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/8/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
STEVEN T. ANDREWS, CFO
(269) 273-9604
Contract Pharmacy Representative
Onco360 Oncology Pharmacy
Jim Bozora, VP of 340B Oncology Sales
(702) 281-5985
Signed By Date
4/5/2018
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