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UMMS PHARMACY SERVICES
DSH210058 JAMES LAWRENCE KERNAN HOSPITAL
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Covered Entity Details
Entity Name
JAMES LAWRENCE KERNAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210058
Entity Address
2200 KERNAN DRIVE
BALTIMORE, MD 21207
Medicare Provider Number
210058
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
UMMS PHARMACY SERVICES
Pharmacy Address
UMMS PHARMACY SERVICES
920 ELKRIDGE LANDING ROAD
SUITE 1W111
LINTHICUM, MD 21090
Pharmacy Comments
Contract Details
Approval Date
3/7/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marina Bogin, Vice President Finance
(410) 448-6289
Contract Pharmacy Representative
UMMS
Ronald Cummins, SVP & COO
(410) 328-2700
Signed By Date
1/14/2025
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