340B Drug Pricing Program Database
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DSH210015E FRANKLIN SQUARE HOSPITAL (Active)
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Main Details
Name
FRANKLIN SQUARE HOSPITAL
Subdivision Name
MedStar Franklin Square Hospital - MFS Cancer Infusion @ Loch Raven
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH210015E
Medicare Provider Number
210015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/5/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/25/2018
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Union Memorial Hospital
Deana Stout, VP FINANCE
(410) 554-2228
Primary Contact
MedStar Franklin Square and MedStar Harbor Hospital
Daisy Butrim, Multi-site 340B Program Manager
(443) 777-8429
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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