Covered Entity Details

DSH210003A Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center (Active) - information as of 5/26/2025 1:00:00 AM

Main Details

Name

Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center

Subdivision Name

University of Maryland Bowie Health Center - EMG Emergency Services

Type

Disproportionate Share Hospital

Rural

340B ID

DSH210003A

Medicare Provider Number

210003

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

5/12/2008

Participating Start Date

4/1/2015

Participating Approval Date

5/12/2008

Last Recertification Date

8/28/2024

Contacts

Authorizing Official

University of Maryland Capital Region Health
Michael Brozic, Chief Financial Officer
(410) 913-1546

Primary Contact

University of Maryland Capital Region Health
Lea Wade, 340B Analyst
(301) 237-4404

Addresses

Street Address

15001 HEALTH CENTER DRIVE
BOWIE, MD 20716

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
3/18/15 participating 7/1/2005 thru 9/30/13, not participating 10/1/13 thru 3/31/15 (voluntary withdrawal), reinstated effective 4/1/15 based on on-line registration submitted in January 2015	03/18/2015
6/19/2009- DOC RECD TO CONFIRM ELIG DSH ADJ %	05/12/2008

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MD	000345001	1720099286
DC	023573700401	1720099286

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH210003A	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	University of Maryland Bowie Health Center - EMG Emergency Services	15001 HEALTH CENTER DRIVE	BOWIE	MD	Active
DSH210003B	Child	DSH	PRINCE GEORGES HOSPITAL	Trauma Clinic	3001 Hospital Drive	Cheverly	MD	Terminated
DSH210003C	Child	DSH	PRINCE GEORGES HOSPITAL	Orthopedic Clinic	3001 Hospital Drive	Cheverly	MD	Terminated
DSH210003D	Child	DSH	PRINCE GEORGES HOSPITAL	Dietary Consults	3001 Hospital Drive	Cheverly	MD	Terminated
DSH210003E	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Radiology	7150 Contee Road	Laurel	MD	Active
DSH210003F	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Nuclear Medicine	7150 Contee Road	Laurel	MD	Active
DSH210003G	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Respiratory Therapy	7150 Contee Road	Laurel	MD	Active
DSH210003H	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Emergency Services	7150 Contee Road	Laurel	MD	Active
DSH210003J	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Anesthesiology	7150 Contee Road	Laurel	MD	Active
DSH210003K	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - CT SCAN	7150 Contee Road	Laurel	MD	Active
DSH210003L	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Hyperbaric Services	7400 Van Dusen	Laurel	MD	Active
DSH210003M	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Observation	7150 Contee Road	Laurel	MD	Active
DSH210003N	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Lithotripsy	7150 Contee Road	Laurel	MD	Active
DSH210003P	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Psych Clinic	7150 Contee Road	Laurel	MD	Active
DSH210003Q	Child	DSH	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	UM LAUREL MEDICAL CENTER - Operating Room	7150 Contee Road	Laurel	MD	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/25/2023 7:36:30 AM	8/28/2024 5:29:51 PM	8/28/2024 5:29 PM
Details	Last Recertification Date	Update	Recertification	9/1/2022 10:55:16 AM	8/25/2023 7:36:30 AM	8/25/2023 7:36 AM
Contacts	Authorizing Official	Update	AO Change Request	Godwin, Min Chief Operating Officer UM Capital Region Health System 2127679602	Brozic, Michael Chief Financial Officer University of Maryland Capital Region Health 4109131546	6/27/2023 2:22 PM
Contacts	Primary Contact	Update	Recertification	Butler, Demetris VP Clinical Support Services Univ of Maryland Capital Region 2406064589	Wade, Lea 340B Analyst University of Maryland Capital Region Health 3012374404	9/1/2022 10:55 AM
Details	Last Recertification Date	Update	Recertification	9/10/2021 9:03:56 AM	9/1/2022 10:55:16 AM	9/1/2022 10:55 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	023573700417 (DC)		9/10/2021 9:03 AM
Contacts	Primary Contact	Update	Recertification	BUTLER, DEE Corporate Director, Pharmacy Services Dimension Healthcare System Prince Georges Hospital Center 3014978773	Butler, Demetris VP Clinical Support Services Univ of Maryland Capital Region 2406064589	9/10/2021 9:03 AM
Details	Last Recertification Date	Update	Recertification	9/10/2020 8:49:26 AM	9/10/2021 9:03:56 AM	9/10/2021 9:03 AM
Details	Entity Name	Update	Change Request	Dimensions Health Corporation d/b/a University of Maryland Prince Georges Hospital Center	Dimensions Health Corporation d/b/a University of Maryland Capital Region Medical Center	6/9/2021 2:27 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/14/2020 5:54 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		023573700401	12/14/2020 5:54 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		DC	12/14/2020 5:54 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/14/2020 5:54 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		023573700417	12/14/2020 5:54 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		DC	12/14/2020 5:54 PM
Contacts	Authorizing Official	Update	Profile Change Request	Godwin, Min Interim COO UM Capital Region Health System 2127679602	Godwin, Min Chief Operating Officer UM Capital Region Health System 2127679602	9/10/2020 8:54 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	000345000 (MD)		9/10/2020 8:49 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	023573700 (DC)		9/10/2020 8:49 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1720099286 (VA)		9/10/2020 8:49 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/10/2020 8:49 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		000345001	9/10/2020 8:49 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		MD	9/10/2020 8:49 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1720099286	9/10/2020 8:49 AM
Medicaid Billing	NPI: State	Insert	Recertification		MD	9/10/2020 8:49 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1720099286	9/10/2020 8:49 AM
Medicaid Billing	NPI: State	Insert	Recertification		DC	9/10/2020 8:49 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1720099286 ( )		9/10/2020 8:49 AM
Details	Last Recertification Date	Update	Recertification	9/9/2019 10:19:35 AM	9/10/2020 8:49:26 AM	9/10/2020 8:49 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/13/2019 5:52 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		023573700	12/13/2019 5:52 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		DC	12/13/2019 5:52 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/13/2019 5:52 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1720099286	12/13/2019 5:52 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		VA	12/13/2019 5:52 PM
Details	Last Recertification Date	Update	Recertification	9/4/2018 4:33:11 PM	9/9/2019 10:19:35 AM	9/9/2019 10:19 AM
Contacts	Authorizing Official	Update	AO Change Request	Brosius, Bill Chief Financial Officer Dimensions Health Corp d/b/a University of Maryland Prince Georges Hospital Center 3016182556	Godwin, Min Interim COO UM Capital Region Health System 2127679602	6/25/2019 7:11 AM
Details	Last Recertification Date	Update	Recertification	12/4/2017 10:03:03 AM	9/4/2018 4:33:11 PM	9/4/2018 4:33 PM
Contacts	Authorizing Official	Update	Change Request	MOORE, NEIL J. ACTING PRESIDENT AND CEO Dimensions Healthcare System 3016182109	Brosius, Bill Chief Financial Officer Dimensions Health Corp d/b/a University of Maryland Prince Georges Hospital Center 3016182556	6/21/2018 9:02 AM
Details	Entity Name	Update	Change Request	PRINCE GEORGES HOSPITAL	Dimensions Health Corporation d/b/a University of Maryland Prince Georges Hospital Center	2/27/2018 2:30 PM
Details	Entity Subname	Update	Change Request	Bowie Health Center - EMG Emergency Services	University of Maryland Bowie Health Center - EMG Emergency Services	2/6/2018 11:18 AM
Details	Last Recertification Date	Update	Recertification	8/16/2016 12:00:00 AM	12/4/2017 10:03:03 AM	12/4/2017 10:03 AM
Contacts	Authorizing Official	Update		MOORE, NEIL J. ACTING PRESIDENT AND CEO 3016182109	MOORE, NEIL J. ACTING PRESIDENT AND CEO Dimensions Healthcare System 3016182109	10/23/2017 2:58 PM
Contacts	Primary Contact	Update		BUTLER, DEE Corporate Director, Pharmacy Services Dimension Healthcare System 3014978773	BUTLER, DEE Corporate Director, Pharmacy Services Dimension Healthcare System Prince Georges Hospital Center 3014978773	10/2/2017 11:53 AM
Addresses	Main Address	Insert			15001 HEALTH CENTER DRIVE BOWIE, MD 20716	8/17/2016 1:53 PM
Contacts	Authorizing Official	Insert			MOORE, NEIL J. ACTING PRESIDENT AND CEO 3016182109	8/17/2016 1:53 PM
Contacts	Primary Contact	Update		Butler, Dee Corporate Director, Pharmacy Services Dimension Healthcare System 3014978773	BUTLER, DEE Corporate Director, Pharmacy Services Dimension Healthcare System 3014978773	8/17/2016 1:53 PM
Details	Last Recertification Date	Update		9/8/2015 12:00:00 AM	8/16/2016 12:00:00 AM	8/17/2016 1:53 PM
Details	Last Recertification Date	Update			9/8/2015 12:00:00 AM	9/8/2015 9:55 AM
Contacts	Primary Contact	Insert			Butler, Dee Corporate Director, Pharmacy Services Dimension Healthcare System 3014978773	3/26/2015 9:48 AM
Details	Last Recertification Date	Update		9/12/2013 12:00:00 AM		3/18/2015 3:40 PM
Dates	Last Date That 340B Drugs Purchased	Update		10/1/2013 12:00:00 AM		3/18/2015 3:40 PM
Details	Entity Name	Update		PRINCE GEORGE'S HOSPITAL CENTER	PRINCE GEORGES HOSPITAL	3/18/2015 3:40 PM
Details	Entity Subname	Update		BOWIE HEALTH CENTER	Bowie Health Center - EMG Emergency Services	3/18/2015 3:40 PM
Details	State	Update		Terminated	Active	3/18/2015 3:40 PM
Dates	Start Date	Update		7/1/2005 12:00:00 AM	4/1/2015 12:00:00 AM	3/18/2015 3:40 PM
Terminations	Termination Comments	Update		Software implementation.		3/18/2015 3:40 PM
Terminations	Termination Date	Update		10/1/2013 12:00:00 AM		3/18/2015 3:40 PM
Terminations	Termination Effective Date	Update		10/1/2013 12:00:00 AM		3/18/2015 3:40 PM
Terminations	Termination Reason	Update		Voluntary withdrawal		3/18/2015 3:40 PM
Details	Comments Public	Insert			3/18/15 participating 7/1/2005 thru 9/30/13, not participating 10/1/13 thru 3/31/15 (voluntary withdrawal), reinstated effective 4/1/15 based on on-line registration submitted in January 2015	3/18/2015 3:40 PM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	9/12/2013 12:00:00 AM	9/12/2013 8:29 PM
Dates	Last Date That 340B Drugs Purchased	Update			10/1/2013 12:00:00 AM	9/12/2013 8:29 PM
Details	State	Update		Active	Terminated	9/12/2013 8:29 PM
Terminations	Termination Comments	Update			Software implementation.	9/12/2013 8:29 PM
Terminations	Termination Date	Update			10/1/2013 12:00:00 AM	9/12/2013 8:29 PM
Terminations	Termination Effective Date	Update			10/1/2013 12:00:00 AM	9/12/2013 8:29 PM
Terminations	Termination Reason	Update			Voluntary withdrawal	9/12/2013 8:29 PM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	5/29/2012 12:20 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	3/26/2012 10:33 AM
Medicaid Billing	Medicaid: Number	Insert			000345000	3/26/2012 10:33 AM
Medicaid Billing	Medicaid: State	Insert			MD	3/26/2012 10:33 AM
Medicaid Billing	NPI: Number	Insert			1720099286	3/26/2012 10:33 AM
Details	Last Recertification Date	Insert				5/12/2008 11:22 AM
Details	Grant Number	Insert				5/12/2008 11:22 AM
Details	340B ID	Insert			DSH210003A	5/12/2008 11:22 AM
Details	Is Authorizing Official EHB Data	Insert				5/12/2008 11:22 AM
Dates	Last Date That 340B Drugs Purchased	Insert				5/12/2008 11:22 AM
Details	Medicare Provider Number	Insert			210003	5/12/2008 11:22 AM
Details	Entity Name	Insert			PRINCE GEORGE'S HOSPITAL CENTER	5/12/2008 11:22 AM
Details	Program Code	Insert			DSH	5/12/2008 11:22 AM
Details	Entity Subname	Insert			BOWIE HEALTH CENTER	5/12/2008 11:22 AM
Dates	Participating Approval Date	Insert			5/12/2008 12:00:00 AM	5/12/2008 11:22 AM
Details	State	Insert			Active	5/12/2008 11:22 AM
Dates	Registration Date	Insert			5/12/2008 12:00:00 AM	5/12/2008 11:22 AM
Dates	Signed By Date	Insert				5/12/2008 11:22 AM
Dates	Start Date	Insert			7/1/2005 12:00:00 AM	5/12/2008 11:22 AM
Terminations	Termination Comments	Insert				5/12/2008 11:22 AM
Terminations	Termination Date	Insert				5/12/2008 11:22 AM
Terminations	Termination Effective Date	Insert				5/12/2008 11:22 AM
Terminations	Termination Reason	Insert				5/12/2008 11:22 AM
Details	Comments Public	Insert			6/19/2009- DOC RECD TO CONFIRM ELIG DSH ADJ %	5/12/2008 11:22 AM