Covered Entity Details

DSH390142B ALBERT EINSTEIN MEDICAL CENTER (Terminated) - information as of 6/14/2025 10:00:04 AM

Main Details

Name

ALBERT EINSTEIN MEDICAL CENTER

Subdivision Name

PSYCH EMERGENCY GERMANTOWN

Type

Disproportionate Share Hospital

Rural

340B ID

DSH390142B

Medicare Provider Number

390142

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

2/10/2009

Participating Start Date

4/1/2009

Participating Approval Date

2/18/2009

Last Recertification Date

8/30/2018

Termination Date
Termination Reason

1/1/2019
Outpatient facility moved within the 4 walls of the parent hospital

Contacts

Authorizing Official

Einstein Healthcare Network
GERARD BLANEY, CHIEF FINANCIAL OFFICER
(215) 456-6020

Primary Contact

Einstein Healthcare Network
Deborah Hauser, Director, Pharmacy Services
(215) 456-6486

Addresses

Street Address

ONE PENN BOULEVARD
PHILADELPHIA, PA 19144

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

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
PA	1007544140015,1007544140081,1007544140096,1007544140069,1007544140099
		1518000686,1902805245,1104989474,1174522114,1881798320,1891010229

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
DSH390142A	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	ALBERT EINSTEIN CANCER CENTER @ CENTER ONE	9880 Bustleton Avenue	Philadelphia	PA	Active
DSH390142AA	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Observation MA5B - Observation	60 Township Line Road	Elkins Park	PA	Terminated
DSH390142AB	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Observation MA2C - Observation	60 Township Line Road	Elkins Park	PA	Terminated
DSH390142AC	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Center For Wound Healing - Wound Healing	1200 West Tabor Road	Philadelphia	PA	Active
DSH390142AD	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Rheumatology Outpatient - Rheumatology Outpatient	5401 Old York Road	Philadelphia	PA	Active
DSH390142AE	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Outpatient Gastroenterology - Outpatient Gastroenterology	5401 Old York Road	Philadelphia	PA	Active
DSH390142AF	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Albert Einstein Medical Center-Neurology - Neurology	5401 Old York Road	Philadelphia	PA	Active
DSH390142AG	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Albert Einstein Medical Center-Pulmonary - Pulmonary	5401 Old York Road	Philadelphia	PA	Active
DSH390142AH	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Endocrinology - EP - Endocrinology	50 East Township Line Road	Elkins Park	PA	Active
DSH390142B	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	PSYCH EMERGENCY GERMANTOWN	ONE PENN BOULEVARD	PHILADELPHIA	PA	Terminated
DSH390142D	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	AMBULATORY SURGERY CENTER ONE	9880 Bustleton Avenue	Philadelphia	PA	Active
DSH390142E	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	ANESTHESIOLOGY ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142F	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	ECHO/STRESS LAB ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142G	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	EMERGENCY DEPARTMENT ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142H	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	GAIT ANALYSIS LAB ELKINS PARK	60 Township Line Road	Elkins Park	PA	Active
DSH390142J	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	MOTOR CONTROL LAB ELKINS PARK	60 Township Line Road	Elkins Park	PA	Active
DSH390142K	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	OPERATING ROOM ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142L	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	RADIOLOGY CENTER ONE	9880 Bustleton Avenue	Philadelphia	PA	Active
DSH390142M	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	RADIOLOGY CT SCAN ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142N	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	RADIOLOGY DIAGNOSTIC ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142P	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	RADIOLOGY MRI ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142Q	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	RECOVERY ROOM ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142R	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	RESPIRATORY THERAPY/EKG ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142S	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	SHORT PROCEDURE UNIT ELKINS PARK	60 TOWNSHIP LINE ROAD	ELKINS PARK	PA	Terminated
DSH390142T	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Center One-EMG/Diagnostics	9880 Bustleton Avenue	Philadelphia	PA	Active
DSH390142U	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Anesthesia Pain Center	1200 W Tabor Road	Philadelphia	PA	Active
DSH390142V	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Hepatology/Liver	5401 Old York Road	Philadelphia	PA	Active
DSH390142W	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Kidney Acquisition/Transplant	5401 Old York Road	Philadelphia	PA	Active
DSH390142X	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Gastroenterology Procedures	1200 West Tabor Road	Philadelphia	PA	Active
DSH390142Y	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Observation MA2P - Observation	60 Township Line Road	Elkins Park	PA	Terminated
DSH390142Z	Child	DSH	ALBERT EINSTEIN MEDICAL CENTER	Observation MA5A - Observation	60 Township Line Road	Elkins Park	PA	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		10/16/2018 12:00:00 AM	10/19/2018 1:52 PM
Details	State	Update	Termination Request	Active	To Be Terminated	10/19/2018 1:52 PM
Terminations	Termination Comments	Update	Termination Request		On October 17, 2018, our Psych Emergency Room (aka Crisis Response Center) moved from its child site location to within the four walls of the parent hospital.	10/19/2018 1:52 PM
Terminations	Termination Date	Update	Termination Request		1/1/2019 12:00:00 AM	10/19/2018 1:52 PM
Terminations	Termination Effective Date	Update	Termination Request		10/17/2018 12:00:00 AM	10/19/2018 1:52 PM
Terminations	Termination Reason	Update	Termination Request		Outpatient facility moved within the 4 walls of the parent hospital	10/19/2018 1:52 PM
Details	Last Recertification Date	Update	Recertification	11/17/2017 9:50:46 AM	8/30/2018 10:54:32 AM	8/30/2018 10:54 AM
Contacts	Authorizing Official	Update	Profile Change Request	BLANEY, GERARD VICE PRESIDENT FINANCE Einstein Healthcare Network 2154566020	BLANEY, GERARD CHIEF FINANCIAL OFFICER Einstein Healthcare Network 2154566020	8/30/2018 10:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	11/17/2017 9:50 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1007544140096	11/17/2017 9:50 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		PA	11/17/2017 9:50 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	11/17/2017 9:50 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1007544140069	11/17/2017 9:50 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		PA	11/17/2017 9:50 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1174522114	11/17/2017 9:50 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1881798320	11/17/2017 9:50 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1891010229	11/17/2017 9:50 AM
Details	Last Recertification Date	Update	Recertification	8/12/2016 12:00:00 AM	11/17/2017 9:50:46 AM	11/17/2017 9:50 AM
Contacts	Authorizing Official	Update		BLANEY, GERARD VICE PRESIDENT FINANCE 2154566020	BLANEY, GERARD VICE PRESIDENT FINANCE Einstein Healthcare Network 2154566020	10/20/2017 12:58 PM
Contacts	Primary Contact	Update		Hauser, Deborah Director, Pharmacy Services 2154566486	Hauser, Deborah Director, Pharmacy Services Einstein Healthcare Network 2154566486	10/9/2017 3:20 PM
Contacts	Primary Contact	Insert			Hauser, Deborah Director, Pharmacy Services 2154566486	7/25/2017 8:40 AM
Contacts	Authorizing Official	Insert			BLANEY, GERARD VICE PRESIDENT FINANCE 2154566020	7/25/2017 8:40 AM
Addresses	Main Address	Insert			ONE PENN BOULEVARD PHILADELPHIA, PA 19144	4/20/2017 5:41 PM
Details	Last Recertification Date	Update		8/14/2015 12:00:00 AM	8/12/2016 12:00:00 AM	8/12/2016 2:29 PM
Medicaid Billing	Medicaid: Is Primary	Update		True	False	8/14/2015 9:50 AM
Details	Last Recertification Date	Update		8/19/2014 12:00:00 AM	8/14/2015 12:00:00 AM	8/14/2015 9:50 AM
Details	Last Recertification Date	Update		8/29/2013 12:00:00 AM	8/19/2014 12:00:00 AM	8/19/2014 11:46 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	3/23/2014 7:56 PM
Medicaid Billing	Medicaid: Number	Insert			1007544140015	3/23/2014 7:56 PM
Medicaid Billing	Medicaid: State	Insert			PA	3/23/2014 7:56 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	3/23/2014 7:56 PM
Medicaid Billing	Medicaid: Number	Insert			1007544140081	3/23/2014 7:56 PM
Medicaid Billing	Medicaid: State	Insert			PA	3/23/2014 7:56 PM
Medicaid Billing	NPI: Number	Insert			1902805245	3/23/2014 7:56 PM
Medicaid Billing	NPI: Number	Insert			1104989474	3/23/2014 7:56 PM
Details	Last Recertification Date	Update		8/29/2013 9:42:41 AM	8/29/2013 12:00:00 AM	3/23/2014 7:56 PM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	8/29/2013 9:42:41 AM	8/29/2013 9:42 AM
Details	Entity Subname	Update		GERMANTOWN COMMUNITY HEALTH SERVICES	PSYCH EMERGENCY GERMANTOWN	10/22/2012 9:45 AM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	5/18/2012 12:30 PM
Medicaid Billing	Medicaid: Number	Update		1007544140015	1007544140099	3/26/2012 9:47 AM
Medicaid Billing	NPI: Number	Insert			1518000686	3/26/2012 9:47 AM
Details	Last Recertification Date	Insert				2/18/2009 10:00 AM
Details	Grant Number	Insert				2/18/2009 10:00 AM
Details	340B ID	Insert			DSH390142B	2/18/2009 10:00 AM
Details	Is Authorizing Official EHB Data	Insert				2/18/2009 10:00 AM
Dates	Last Date That 340B Drugs Purchased	Insert				2/18/2009 10:00 AM
Details	Medicare Provider Number	Insert			390142	2/18/2009 10:00 AM
Details	Entity Name	Insert			ALBERT EINSTEIN MEDICAL CENTER	2/18/2009 10:00 AM
Details	Program Code	Insert			DSH	2/18/2009 10:00 AM
Details	Entity Subname	Insert			GERMANTOWN COMMUNITY HEALTH SERVICES	2/18/2009 10:00 AM
Dates	Participating Approval Date	Insert			2/18/2009 12:00:00 AM	2/18/2009 10:00 AM
Details	State	Insert			Active	2/18/2009 10:00 AM
Dates	Registration Date	Insert			2/10/2009 12:00:00 AM	2/18/2009 10:00 AM
Dates	Signed By Date	Insert			11/24/2008 12:00:00 AM	2/18/2009 10:00 AM
Dates	Start Date	Insert			4/1/2009 12:00:00 AM	2/18/2009 10:00 AM
Terminations	Termination Comments	Insert				2/18/2009 10:00 AM
Terminations	Termination Date	Insert				2/18/2009 10:00 AM
Terminations	Termination Effective Date	Insert				2/18/2009 10:00 AM
Terminations	Termination Reason	Insert				2/18/2009 10:00 AM
Medicaid Billing	Medicaid: Is Primary	Insert			True	2/10/2009 9:34 AM
Medicaid Billing	Medicaid: Number	Insert			1007544140015	2/10/2009 9:34 AM
Medicaid Billing	Medicaid: State	Insert			PA	2/10/2009 9:34 AM