340B Drug Pricing Program Database
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SCH210028-00 ST. MARYS HOSPITAL (Active)
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Main Details
Name
ST. MARYS HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
No
340B ID
SCH210028-00
Medicare Provider Number
210028
Additional Details
Current Program Status
Active
Registration Date
9/7/2018
Participating Start Date
10/1/2018
Participating Approval Date
9/10/2018
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Medstar
purvi jani, CFO
(214) 991-6090
Primary Contact
MedStar St. Mary's Hospital
Michelle Annette Forrest-Smith, Pharmacy Director
(301) 475-6268
Addresses
Street Address
25500 POINT LOOKOUT RD
LEONARDTOWN, MD 20650
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2012, terminated 7/1/2016. Reinstated 10/1/2018.
09/10/2018
April 2025
April 2025
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