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DSH390226A THE PENNSYLVANIA HOSPITAL (Terminated)
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Main Details
Name
THE PENNSYLVANIA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390226A
Medicare Provider Number
390226
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/3/2008
Participating Start Date
7/1/2004
Participating Approval Date
1/3/2008
Last Recertification Date
9/5/2018
Termination Date
Termination Reason
1/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Pennsylvania Hospital
Frank Anastasi, Chief Financial Officer
(215) 829-8428
Primary Contact
Pennsylvania Hospital
Suzanne Y. Brown, Director of Pharmacy Services
(215) 829-5847
Addresses
Street Address
800 SPRUCE STREET
SPRUCE BUILDING
PHILADELPHIA, PA 19107
Billing Address
Pennsylvania Hospital
800 Spruce St.
Pharmacy, Cathcart Bldg, Basement
Philadelphia, PA 19107
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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