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BALTIMORE HIGHLANDS PHARMACY
CH033180 BALTIMORE MEDICAL SYSTEM, INC.
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Covered Entity Details
Entity Name
BALTIMORE MEDICAL SYSTEM, INC.
Subdivision Name
BMS at Yard 56
Type
HRSA-Funded Health Center
340B ID
CH033180
Entity Address
5525 Eastern Avenue
Suite 301
Baltimore, MD 21224-2029
Grant Number
H80CS00800
Participating Start Date
10/1/1998
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
BALTIMORE HIGHLANDS PHARMACY
Pharmacy Address
4109 ANNAPOLIS RD
BALTIMORE, MD 21227-3605
Pharmacy Comments
Contract Details
Approval Date
4/16/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JAY WOLVOVSKY, EXECUTIVE DIRECTOR
(410) 558-4891
Contract Pharmacy Representative
Signed By Date
4/16/2013
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