340B Drug Pricing Program Database

Name

JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC.

Subdivision Name

JOHNS HOPKINS ALL CHILDREN'S OUTPATIENT CARE CENTER (CHRONIC PAIN CLINIC)

Type

Children's Hospital

Rural

No

340B ID

PED103300-28

Medicare Provider Number

103300

Outpatient Facility Provider Number

Current Program Status

Terminated

Registration Date

1/2/2018

Participating Start Date

4/1/2018

Participating Approval Date

1/5/2018

Last Recertification Date

9/1/2020

Termination Date
Termination Reason

1/1/2021
Business decision by the Covered Entity

Authorizing Official

Johns Hopkins All Children's Hospital
Thomas D Kmetz, President
(727) 767-6873

Primary Contact

Johns Hopkins All Children's Hospital, Inc.
Pamela Kravitz, Pharmacy Business Manager
(727) 767-2039

Street Address

601 5th Street South-Suite 306
St. Petersburg, FL 33701

Billing Address

Johns Hopkins Enterprise
JH A/P Shared Service Center
PO Box #33499
Baltimore, MD 21218