340B Drug Pricing Program Database
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DSH390223AL PENN PRESBYTERIAN MEDICAL CENTER (Approved)
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Main Details
Name
PENN PRESBYTERIAN MEDICAL CENTER
Subdivision Name
PMUC MRI - MRI
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390223AL
Medicare Provider Number
390223
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/8/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/27/2025
Last Recertification Date
Contacts
Authorizing Official
Penn Presbyterian Medical Center
Gene Gofman, Chief Financial Officer
(215) 662-9863
Primary Contact
Penn Presbyterian Medical Center
Justin Kuratnick, Director of Pharmacy
(215) 662-9291
Addresses
Street Address
3737 Market Street
7th Floor
Philadelphia, PA 19104
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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