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DSH210002Q UNIVERSITY OF MARYLAND MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF MARYLAND MEDICAL CENTER
Subdivision Name
UMH: Geropsych Mgmt Proj
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210002Q
Medicare Provider Number
210002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/24/2014
Last Recertification Date
8/21/2018
Termination Date
Termination Reason
1/1/2019
Other
Contacts
Authorizing Official
University of Maryland Medical System
Craig Fleischmann, Vice President of Finance
(410) 328-1092
Primary Contact
University of Maryland Medical Center
Joseph Dicubellis, Senior Director of Pharmacy
(410) 328-6746
Addresses
Street Address
701 W Pratt Street
1st Floor
Baltimore, MD 21201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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