340B Drug Pricing Program Database
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DSH210002Z UNIVERSITY OF MARYLAND MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF MARYLAND MEDICAL CENTER
Subdivision Name
UMH: Psyn Ambltry Child - Psychology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210002Z
Medicare Provider Number
210002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/4/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/10/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
University of Maryland Medical Center
Joseph Dicubellis, Senior Director of Pharmacy
(410) 328-6746
Primary Contact
University of Maryland Medical Center
Robert Stachowski, Director of Business and 340B Operations
(410) 328-6886
Addresses
Street Address
701 W Pratt Street
2nd Floor
Baltimore, MD 21201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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