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JOHNS HOPKINS PHARMAQUIP, INC. D/B/A
DSH210009 JOHNS HOPKINS HOSPITAL
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Covered Entity Details
Entity Name
JOHNS HOPKINS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210009
Entity Address
600 NORTH WOLFE STREET
BALTIMORE, MD 21287
Medicare Provider Number
210009
Participating Start Date
7/1/2002
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
JOHNS HOPKINS PHARMAQUIP, INC. D/B/A
Pharmacy Address
JOHNS HOPKINS OUTPATIENT PHARMACY
10710 CHARTER DRIVE
SUITE 150
COLUMBIA, MD 21044-2858
Pharmacy Comments
Contract Details
Approval Date
10/16/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/17/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
RONALD J. WERTHMAN, CFO
(410) 735-6505
Contract Pharmacy Representative
Johns Hopkins Home Care Group
Nathan Thompson, Director, OPD Pharmacy
(410) 288-8022
Signed By Date
10/16/2013
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