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PED103300-03 JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC. (Active)
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Main Details
Name
JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC.
Subdivision Name
ACH TMP SPECIAL PROCS
Type
Children's Hospital
Rural
No
340B ID
PED103300-03
Medicare Provider Number
103300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/19/2016
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Johns Hopkins All Children's Hospital, Inc.
Kristy Alicia Kim Schulhof, President
(317) 775-3507
Primary Contact
Johns Hopkins All Children's Hospital, Inc.
Pamela Kravitz, Pharmacy Business Manager
(727) 767-2039
Addresses
Street Address
12220 Bruce B Downs Blvd.-Room 199
Tampa, FL 33612
Billing Address
Johns Hopkins Enterprise
JH A/P Shared Service Center
PO Box #33499
Baltimore, MD 21218
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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