340B Drug Pricing Program Database
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DSH210012F SINAI HOSPITAL OF BALTIMORE (Terminated)
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Main Details
Name
SINAI HOSPITAL OF BALTIMORE
Subdivision Name
Adult Psych Partial Hospital Program
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210012F
Medicare Provider Number
210012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/14/2013
Last Recertification Date
8/26/2021
Termination Date
Termination Reason
7/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
LifeBridge Health
NEIL MELTZER, PRESIDENT/CEO
(410) 601-5134
Primary Contact
Sinai Hospital
Lisa Polinsky, AVP, Pharmacy Services
(410) 601-4274
Addresses
Street Address
2440 Cylburn Avenue, 2nd Floor
Baltimore, MD 21215
Billing Address
SINAI HOSPITAL OF BALTIMORE
2401 W. BELVEDERE AVENUE
BALTIMORE, MD 21215
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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