340B Drug Pricing Program Database
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PED093300-56 Children's National Medical Center (Active)
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Main Details
Name
Children's National Medical Center
Subdivision Name
CHILDREN'S HOSPITAL - Takoma Theatre
Type
Children's Hospital
Rural
No
340B ID
PED093300-56
Medicare Provider Number
093300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/19/2022
Participating Start Date
11/18/2022
Participating Approval Date
11/9/2022
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
6833 4TH ST NW
WASHINGTON, DC 20012-1901
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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