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FP212012 UNIVERSITY OF MARYLAND (Active)
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Main Details
Name
UNIVERSITY OF MARYLAND
Subdivision Name
Community Pediatrics and Adolescent Medicine
Type
Family Planning (Title X only)
340B ID
FP212012
Grant Number
FPHPA036069
Additional Details
Current Program Status
Active
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
3/24/2004
Last Recertification Date
5/5/2025
Contacts
Authorizing Official
University of Maryland
Vicki Tepper, CHIEF, DIVISION OF ADOLESCENT & YOUNG ADULT MEDICINE
(410) 706-8931
Primary Contact
University of Maryland School of Medicine
Matthew Grant, MD
(410) 706-8929
Addresses
Street Address
120 PENN STREET AYAC CLINIC
BALTIMORE, MD 21201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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3/31/06 UPDATED NAME (DELETED BALTIMORE DEPT OF PEDIATRICS)
02/05/2010
June 2025
June 2025
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