Contract Pharmacy Details

SINA DRUG LLC
CAH151317-00 GREENE COUNTY GENERAL HOSPITAL

Covered Entity Details

Entity Name

GREENE COUNTY GENERAL HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH151317-00

Entity Address

1185 N 1000 W
LINTON, IN 47441-9457

Medicare Provider Number

151317

Participating Start Date

1/1/2015

Last Recertification Date

8/26/2024

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

4/13/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/18/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

April Settles, CFO
(812) 847-5212

Contract Pharmacy Representative

Onco360
Leo Gray, Director of Pharmacy
(877) 662-6633 Ext: 1207

Signed By Date

4/13/2018

340B Drug Pricing Program Database