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NATION'S INFUSION AT HOME, LLC
DSH210040 NORTHWEST HOSPITAL CENTER, INC.
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Covered Entity Details
Entity Name
NORTHWEST HOSPITAL CENTER, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210040
Entity Address
5401 OLD COURT ROAD
RANDALLSTOWN, MD 21133
Medicare Provider Number
210040
Participating Start Date
10/1/2015
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
NATION'S INFUSION AT HOME, LLC
Pharmacy Address
NATION'S INFUSION AT HOME, LLC
11521 CRONRIDGE DR STE L
OWINGS MILLS, MD 21117
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leslie Simmons, Interim President
(410) 601-7346
Contract Pharmacy Representative
Nations Infusion at Home, LLC
Michele Compton-Plummer, Director of Pharmacy
(410) 753-3912
Signed By Date
10/14/2024
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