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DSH210062 MEDSTAR SOUTHERN MARYLAND HOSPITAL C (Active)
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Main Details
Name
MEDSTAR SOUTHERN MARYLAND HOSPITAL C
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210062
Medicare Provider Number
210062
Additional Details
Current Program Status
Active
Registration Date
7/9/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/30/2015
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Medstar
purvi jani, CFO
(214) 991-6090
Primary Contact
MedStar Southern MD Hospital Ctr
Francisca A. Sarfo, Pharmacy Director
(301) 877-5549
Addresses
Street Address
7503 SURRATTS ROAD
CLINTON, MD 20735
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/30/15 Participated starting 4/1/2015, terminated 7/1/2015 due to "site closure...New entity -- unable to comply in time. Will re-register." Reinstated based on new registration submitted in July 2015.
07/30/2015
April 2025
April 2025
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