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DSH210058 JAMES LAWRENCE KERNAN HOSPITAL (Active)
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Main Details
Name
JAMES LAWRENCE KERNAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210058
Medicare Provider Number
210058
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/7/2025
Last Recertification Date
Contacts
Authorizing Official
JAMES LAWRENCE KERNAN HOSPITAL
Marina Bogin, Vice President Finance
(410) 448-6289
Primary Contact
JAMES LAWRENCE KERNAN HOSPITAL
Nadeem Aslam, Pharmacy Director
(410) 448-6816
Addresses
Street Address
2200 KERNAN DRIVE
BALTIMORE, MD 21207
Billing Address
JAMES LAWRENCE KERNAN HOSPITAL
2200 Kernan Drive
Executive office
Suite # 1181
Baltimore, MD 21207
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2008, terminated 1/1/2024. Reinstated 4/1/2025.
01/22/2025
5/20/08-DOC RECD TO CONFIRM ELIG DSH ADJ %
06/05/2008
May 2025
May 2025
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