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PED093300-51 Children's National Medical Center (Active)
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Main Details
Name
Children's National Medical Center
Subdivision Name
Children's National Shepherd Park - Primary Care and Rare Disease Institute
Type
Children's Hospital
Rural
No
340B ID
PED093300-51
Medicare Provider Number
093300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/22/2021
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Childrens National Medical Center
Eric Manuel Balmir, VP Clinical Ancillary Svcs & Chief Pharmacy Officer
(202) 476-5553
Primary Contact
Children's National Medical Center
Michael Hagan, Pharmacy 340B Manager
(301) 572-6275
Addresses
Street Address
7125 13th Place NW
Washington, DC 20012
Billing Address
Children's National
111 Michigan Avenue, NW,
Washington, DC 20010
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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