340B Drug Pricing Program Database
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DSH210004A HOLY CROSS HOSPITAL (Active)
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Main Details
Name
HOLY CROSS HOSPITAL
Subdivision Name
Woodmore Outpatient Dialysis
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210004A
Medicare Provider Number
210004
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/2/2013
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Holy Cross Health, Inc.
Julie D. Keese, Vice President and Chief Financial Officer
(301) 754-7201
Primary Contact
Holy Cross Hospital
Chi Onwumbiko, Director, Pharmacy
(301) 754-7311
Addresses
Street Address
11721 Woodmore Road
Suite 190
Mitchellville, MD 20721
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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