340B Drug Pricing Program Database

Pharmacy Name

SINAI HOSP OF BALTIMORE INC

Pharmacy Address

DEPARTMENT OF PHARMACY
2401 W BELVEDERE AVE
SINAI HOSPITAL OF BALTIMORE
BALTIMORE, MD 21215

Pharmacy Comments

Approval Date

7/28/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/1/2019
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Brian White, President of Northwest Hospital
(410) 701-5995

Contract Pharmacy Representative

Northwest Hospital Center
Rose Jose, Chief Operating Officer of Outpatient Pharmacy Services
(410) 701-4531

Signed By Date

7/28/2015