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SORKIN'S RX LTD
DSH140133 HOLY CROSS HOSPITAL
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Covered Entity Details
Entity Name
HOLY CROSS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140133
Entity Address
2701 WEST 68TH STREET
CHICAGO, IL 60629
Medicare Provider Number
140133
Participating Start Date
7/1/2005
Last Recertification Date
9/5/2024
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
4/14/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Loren Chandler, EVP COO
(773) 257-5658
Contract Pharmacy Representative
Onco360 Oncology Pharmacy
Jim Bozora, VP of 340B Oncology Sales
(702) 281-5985
Signed By Date
4/14/2018
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