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CH03013B PARK WEST HEALTH SYSTEMS INCORPORATED (Active)
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Main Details
Name
PARK WEST HEALTH SYSTEMS INCORPORATED
Subdivision Name
PARK WEST MEDICAL CENTER - PLAZA SITE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005299
340B ID
CH03013B
Grant Number
H80CS00067
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
12/1/1992
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
Park West Health System, Inc.
ALLEN J. BENNETT, PRESIDENT & CEO
(410) 542-7800 Ext: 7501
Primary Contact
Park West Health System, Inc.
Rob Mayes, Pharmacy Director
(443) 884-7558
Addresses
Street Address
4120 PATTERSON AVE
BALTIMORE, MD 21215-2254
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/11/08 CORRECTED ENT NAME (WAS PARK WEST MEDICAL SYSTEMS, INC.); 8/17/05 - ADDR CH (WAS 6776 REISTERTOWN ROAD, SUITE 211), ADMIN CORRECTION - WAS CH03013A
03/11/2008
May 2025
May 2025
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