340B Drug Pricing Program Database
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DSH390204 NAZARETH HOSPITAL (Active)
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Main Details
Name
NAZARETH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390204
Medicare Provider Number
390204
Additional Details
Current Program Status
Active
Registration Date
7/13/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/23/2016
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Trinity Health Mid-Atlantic
Kimberly Cummings, Chief Financial Officer
(215) 710-2508
Primary Contact
Trinity Health Mid Atlantic
Alicia Hayter, 340B Program Manager
(610) 368-3675
Addresses
Street Address
2601 HOLME AVENUE
PHILADELPHIA, PA 19152
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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