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DSH210024A UNION MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
UNION MEMORIAL HOSPITAL
Subdivision Name
UNION MEMORIAL HOSPITAL OUTPATIENT RENAL DIALYSIS UNIT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210024A
Medicare Provider Number
210024
Outpatient Facility Provider Number
210024
Additional Details
Current Program Status
Terminated
Registration Date
9/15/2010
Participating Start Date
10/1/2010
Participating Approval Date
9/16/2010
Last Recertification Date
8/19/2016
Termination Date
Termination Reason
7/1/2017
For-Profit conversion
Contacts
Authorizing Official
Union Memorial Hospital
Deana Stout, VP FINANCE
(410) 554-2228
Primary Contact
MedStar Harbor Hospital
Daryn K Norwood, Director of Pharmacy Services
(410) 350-2587
Addresses
Street Address
201 E UNIVERSITY PARKWAY
BALTIMORE, MD 21218
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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