340B Drug Pricing Program Database
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DSH390226AG THE PENNSYLVANIA HOSPITAL (Active)
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Main Details
Name
THE PENNSYLVANIA HOSPITAL
Subdivision Name
DERMATOLOGY CLINIC - Derm PAH/Derm General PAH/Derm Path PAH
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390226AG
Medicare Provider Number
390226
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/28/2021
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
235 S 8TH ST
PHILADELPHIA, PA 19106-3519
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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