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EASTERN DISCOUNT PHARMACY
CH03318Q BALTIMORE MEDICAL SYSTEM, INC.
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Covered Entity Details
Entity Name
BALTIMORE MEDICAL SYSTEM, INC.
Subdivision Name
BMS AT ST. AGNES
Type
HRSA-Funded Health Center
340B ID
CH03318Q
Entity Address
900 S. Caton Ave
Baltimore, MD 21229-5201
Grant Number
H80CS00800
Participating Start Date
9/9/2005
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
EASTERN DISCOUNT PHARMACY
Pharmacy Address
163 ORVILLE ROAD
BALTIMORE, MD 21221
Pharmacy Comments
Contract Details
Approval Date
7/27/2010
Contract Begin Date
7/27/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jay Wolvovsky, President & CEO
(410) 558-4891
Contract Pharmacy Representative
NASIR MAHMOOD, VICE PRESIDENT
(410) 686-1136
Signed By Date
6/29/2010
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