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DSH390226X THE PENNSYLVANIA HOSPITAL (Active)
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Main Details
Name
THE PENNSYLVANIA HOSPITAL
Subdivision Name
PAH Penn Medicine Washington Square MAPS
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390226X
Medicare Provider Number
390226
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/13/2017
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Pennsylvania Hospital
Lindsay Ayling, CFO
(215) 713-4943
Primary Contact
Pennsylvania Hospital
Glen Bianchini, Director of Pharmacy Services
(215) 829-5847
Addresses
Street Address
800 Walnut St., 9th Fl.
Philadelphia, PA 19107
Billing Address
Pennsylvania Hospital
800 Spruce St.
Philadelphia, PA 19107
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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