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CORAM ALTERNATE SITE SERVICES, INC.
DSH210002 UNIVERSITY OF MARYLAND MEDICAL CENTER
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Covered Entity Details
Entity Name
UNIVERSITY OF MARYLAND MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210002
Entity Address
22 SOUTH GREENE STREET
BALTIMORE, MD 21201
Medicare Provider Number
210002
Participating Start Date
10/1/2001
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
11 H COMMERCE WAY
TOTOWA, NJ 07512
Pharmacy Comments
Contract Details
Approval Date
10/17/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/6/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Keith D. Persinger, Executive Vice President – Chief Operating & Financial Officer
(410) 328-1382
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/17/2017
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