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PED393303-01 THE CHILDREN'S HOSPITAL OF PHILADELPHIA (Terminated)
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Main Details
Name
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Subdivision Name
CHILDRENS HOSPITAL SPECIALTY CARE CTR AT VOORHEES
Type
Children's Hospital
Rural
No
340B ID
PED393303-01
Medicare Provider Number
393303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/16/2009
Participating Start Date
1/1/2010
Participating Approval Date
12/18/2009
Last Recertification Date
8/16/2018
Termination Date
Termination Reason
1/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Children's Hospital of Philadelphia
THOMAS J. TODOROW, EXECUTIVE VICE PRESIDENT FINANCE AND CHIEF FINANCIAL OFFICER
(267) 426-6957
Primary Contact
The Children's Hospital of Philadelphia
Winson Soo-Hoo, Director of Pharmacy
(215) 590-1893
Addresses
Street Address
1012-1014 LAUREL OAK ROAD
VOORHEES, NJ 08043
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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