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DSH390226AF THE PENNSYLVANIA HOSPITAL (Active)
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Main Details
Name
THE PENNSYLVANIA HOSPITAL
Subdivision Name
334396 GI Farm Journal - GI
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390226AF
Medicare Provider Number
390226
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/4/2020
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Pennsylvania Hospital
Lindsay Ayling, CFO
(215) 713-4943
Primary Contact
Pennsylvania Hospital
Glen Bianchini, Director of Pharmacy Services
(215) 829-5847
Addresses
Street Address
230 West Washington Square
4th Floor
Philadelphia, PA 19106
Billing Address
Pennsylvania Hospital
800 Spruce Street
Philadelphia, PA 19107
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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