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HV01703A Kensington Hospital Outpatient Treatment Program (Terminated)
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Main Details
Name
Kensington Hospital Outpatient Treatment Program
Subdivision Name
Kensington Hospital
Type
Ryan White Part C
340B ID
HV01703A
Grant Number
H76HA01703
Additional Details
Current Program Status
Terminated
Registration Date
1/16/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/30/2017
Last Recertification Date
2/14/2019
Time Period the Assistance was Received
Termination Date
Termination Reason
10/1/2019
Other
Contacts
Authorizing Official
Kensington Hospital
Kathleen Lalli, Chief Executive Officer
(215) 426-8100 Ext: 6502
Primary Contact
Kensington Hospital
Maria Zukowski, Executive Assistant
(215) 426-8100 Ext: 6502
Addresses
Street Address
2100 N. Front Street
Philadelphia, PA 19122
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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