340B Drug Pricing Program Database
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DSH210015C FRANKLIN SQUARE HOSPITAL (Active)
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Main Details
Name
FRANKLIN SQUARE HOSPITAL
Subdivision Name
Outpatient Psychiatric Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210015C
Medicare Provider Number
210015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/6/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Union Memorial Hospital
Deana Stout, VP FINANCE
(410) 554-2228
Primary Contact
MedStar Franklin Square and MedStar Harbor Hospital
Daisy Butrim, Multi-site 340B Program Manager
(443) 777-8429
Addresses
Street Address
9105 Franklin Square Drive
Suite 102
Baltimore, MD 21237
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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