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CH03318Y BALTIMORE MEDICAL SYSTEM, INC. (Terminated)
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Main Details
Name
BALTIMORE MEDICAL SYSTEM, INC.
Subdivision Name
BMS Pine Heights Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019652
340B ID
CH03318Y
Grant Number
H80CS00800
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
2/16/2023
Termination Date
Termination Reason
7/1/2023
Site closure
Contacts
Authorizing Official
Baltimore Medical System, Inc.
Shirley Sutton, Chief Executive Officer
(410) 558-4891
Primary Contact
Baltimore Medical System,Inc.
Dawn Jacobs, Director of Pharmacy Services
(443) 703-3654
Addresses
Street Address
1001 Pine Heights Ave, Suite 100
Baltimore, MD 21229
Billing Address
Baltimore Medical System, Inc. Pine Heights Health Center
3501 Sinclair Lane
Baltimore, MD 21213
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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