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JOHNS HOPKINS PHARMAQUIP INC
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
Pharmacy Address
5901 HOLABIRD AVE STE A
BALTIMORE, MD 21224
Pharmacy Comments
Contract Details
Approval Date
1/15/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RONALD J. WERTHMAN, CFO
(410) 735-6505
Contract Pharmacy Representative
Mitra Gavgani, Director, Infusion Services
(443) 690-5066
Signed By Date
1/15/2015
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