340B Drug Pricing Program Database
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DSH100088AQ BAPTIST MEDICAL CENTER (Terminated)
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Main Details
Name
BAPTIST MEDICAL CENTER
Subdivision Name
Cardiology Howard SHG
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100088AQ
Medicare Provider Number
100088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/13/2015
Last Recertification Date
9/8/2022
Termination Date
Termination Reason
7/1/2023
Site closure
Contacts
Authorizing Official
Baptist Medical Center
Scott Finnegan, Senior Vice President of Finance/Treasury
(904) 202-3270
Primary Contact
Baptist Medical Center
Pamela Michelle Johnston, Sr 340B Pharmacy Specialist
(904) 202-5255
Addresses
Street Address
820 Prudential Dr
Howard Bldg Suite 408B
Jacksonville, FL 32207
Billing Address
Baptist Medical Center
PO BOX 45128
Jacksonville, FL 32232
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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