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DSH390226Q THE PENNSYLVANIA HOSPITAL (Active)
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Main Details
Name
THE PENNSYLVANIA HOSPITAL
Subdivision Name
335630 Gamma Knife
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390226Q
Medicare Provider Number
390226
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/9/2013
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Pennsylvania Hospital
Lindsay Ayling, CFO
(215) 713-4943
Primary Contact
Pennsylvania Hospital
Glen Bianchini, Director of Pharmacy Services
(215) 829-5847
Addresses
Street Address
801 Spruce St.
1st Floor
Philadelphia, PA 19107
Billing Address
Pennsylvania Hospital
800 Spruce St.
Philadelphia, PA 19107
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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