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DSH210015D FRANKLIN SQUARE HOSPITAL (Terminated)
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Main Details
Name
FRANKLIN SQUARE HOSPITAL
Subdivision Name
MedStar Franklin Square Hospital - MFS Cancer Med Onc@ Loch Raven
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210015D
Medicare Provider Number
210015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/25/2018
Last Recertification Date
Termination Date
Termination Reason
7/1/2018
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
MedStar Health
Robert P. Lally Jr., CFO
(443) 777-7257
Primary Contact
MedStar Franklin Square Medical Center
Timothy W West, Interim Director of Pharmacy
(443) 777-4983
Addresses
Street Address
5601 Loch Raven Blvd
RMB-Suite 103
Baltimore, MD 21239-2945
Billing Address
MedStar Franklin Square Hospital
9000 Franklin Square Drive
Baltimore, MD 21237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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