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THE JOHNS HOPKINS HOSPITAL
DSH210029 JOHNS HOPKINS BAYVIEW MEDICAL CENTER
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Covered Entity Details
Entity Name
JOHNS HOPKINS BAYVIEW MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210029
Entity Address
4940 EASTERN AVENUE
BALTIMORE, MD 21224
Medicare Provider Number
210029
Participating Start Date
10/1/2001
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
THE JOHNS HOPKINS HOSPITAL
Pharmacy Address
D/B/A JOHNS HOPKINS OUTPATIENT PHARMACY
401 N BROADWAY ST
SUITE 1001
BALTIMORE, MD 21287
Pharmacy Comments
Contract Details
Approval Date
4/25/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RICHARD G BENNETT, President
(410) 550-0781
Contract Pharmacy Representative
Timothy Warner, Assistant Director, Pharmacy Purchasing & 340B Management
(585) 770-0391
Signed By Date
4/25/2016
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