340B Drug Pricing Program Database


DSH490052 RIVERSIDE REGIONAL MEDICAL CENTER (Active) - information as of 5/29/2025 1:48:18 AM

Main Details
RIVERSIDE REGIONAL MEDICAL CENTER
Disproportionate Share Hospital
No
DSH490052
490052


Additional Details
Active
6/10/2008
7/1/2008
6/10/2008
8/16/2024

Contacts

Riverside Healthcare Association Inc
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015

Riverside Health System
Cynthia Williams, VP/Chief Pharmacy Officer
(757) 784-1569

Addresses

500 J Clyde Morris Blvd
NEWPORT NEWS, VA 23601

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
VA49005291366547747
Shipping Addresses

Pavilion Pharmacy
500 J Clyde Morris Blvd
Room 1-501
Newport News, VA 23601

Inpatient Pharmacy
500 J Clyde Morris Blvd
Newport News, VA 23601

Riverside Hospital Inc dba Riverside Pharmacy Chesapeake
110 Wimbledon Square
Suite B
Chesapeake, VA 23320

Riverside Hospital Inc dba Riverside Regional Medical Center Central Pharmacy Distribution
11832 Rock Landing Drive
402
Newport News, VA 23606
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/15/202104/01/2021  04/01/2021
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/15/202104/01/2021  04/01/2021
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/15/202104/01/2021  04/01/2021
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/15/202104/01/2021  04/01/2021
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/15/202104/01/2021  04/01/2021
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624101/15/202104/01/2021 06/30/202307/07/2023
Contract DetailACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607507/07/202310/01/2023  10/01/2023
Contract DetailADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280904/05/201807/01/2018  04/05/2018
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526107/07/202310/01/2023  10/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771307/07/202310/01/2023  10/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267007/07/202310/01/2023  10/01/2023
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522607/16/202410/01/2024  10/01/2024
Contract DetailBIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620307/16/202410/01/2024  10/01/2024
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813307/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237407/13/201710/01/2017  10/01/2017
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/15/202110/01/2021  10/01/2021
Contract DetailCENTERWELL PHARMACY, INC.10737 MARKS WAY
MIRAMARFL3302504/08/202104/12/2021 07/07/202310/05/2023
Contract DetailCENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506904/08/202104/12/2021  04/12/2021
Contract DetailCENTERWELL PHARMACY, INC.11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDOFL3282410/05/202301/01/2024  01/01/2024
Contract DetailCOMMCARE PHARMACY-FTL, LLC855 SW 78TH AVE STE C100
PLANTATIONFL33324-322301/16/201404/01/2014 01/01/201802/16/2018
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/19/202001/01/2021  01/01/2021
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/19/202001/01/2021  01/01/2021
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/16/202110/01/2021  10/01/2021
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/06/202004/01/2020  04/01/2020
Contract DetailDOGWOOD PHARMACY LLCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER RD
STE K 		GREENVILLESC29607-654107/07/202310/01/2023  10/01/2023
Contract DetailESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111201/15/202104/01/2021  04/01/2021
Contract DetailEXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313401/15/202104/01/2021  04/01/2021
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801601/15/202104/01/2021  04/01/2021
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607501/15/202104/01/2021  04/01/2021
Contract DetailGLENDALE PHARMACY12444 WARWICK BOULEVARD
NEWPORT NEWSVA2360609/19/201209/19/2012 06/02/201508/19/2016
Contract DetailHOMECHOICE PARTNERS LLCDBA BIOSCRIP INFUSION SERVICES 5365 ROBIN HOOD RD STE 200
NORFOLKVA2351310/18/201601/01/2017  10/18/2016
Contract DetailHomeChoice Partners, Inc. d/b/a BioScrip Infusion Services12695 McManus Blvd. Suite 1A
Newport NewsVA2360201/29/202004/01/2020  04/01/2020
Contract DetailOPTION CARE ENTERPRISES, INC.D/B/A OPTION CARE 11403 BLUEGRASS PARKWAY
SUITE 400 		LOUISVILLEKY40299-239810/16/201901/01/2020  01/01/2020
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713004/08/202104/12/2021  04/12/2021
Contract DetailOPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265504/08/202104/12/2021  04/12/2021
Contract DetailOPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508504/08/202104/12/2021  04/12/2021
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999201/06/202004/01/2020 12/01/202201/03/2023
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/13/201710/01/2017  10/01/2017
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/15/202110/01/2021  10/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681307/15/202110/01/2021  10/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/15/202110/01/2021  10/01/2021
Contract DetailPROPRIUM PHARMACY535 INDEPENDENCE PKWY STE 400
CHESAPEAKEVA23320-517610/16/201901/01/2020  01/01/2020
Contract DetailRAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103 		NEWBURGHNY1255007/07/202310/01/2023  10/01/2023
Contract DetailRIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500207/07/202310/01/2023  10/01/2023
Contract DetailRIVERSIDE HOSPITAL, INC.D/B/A PAVILION PHARMACY 500 J. CLYDE MORRIS BOULEVARD
ROOM 1-501 		NEWPORT NEWSVA23601-192911/13/201301/01/2014 07/31/202208/01/2022
Contract DetailRIVERSIDE PHARMACY SERVICES  848 J. CLYDE MORRIS BLVD.
NEWPORT NEWSVA2360110/18/201601/01/2017 01/31/201906/05/2019
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 01550 1600 RICHMOND ROAD
WILLIAMSBURGVA2318501/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 2224 7529 RICHMOND ROAD
WILLIAMSBURGVA2318801/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02537 1187 JAMESTOWN ROAD
WILLIAMSBURGVA2318501/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 2315 401 EAST MERCURY BLVD.
HAMPTONVA2366301/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04063 1109 BENN'S CHURCH ROAD
SMITHFIELDVA2343001/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05796 2315 W. MERCURY BLVD.
HAMPTONVA2366601/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #5911 918 W. MERCURY BLVD
HAMPTONVA2366601/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06812 4432 GEORGE WASHINGTON MEM HWY
YORKTOWNVA2369201/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 07081 11127 JEFFERSON AVE.
NEWPORT NEWSVA2360101/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08497 13000 WARWICK BLVD.
NEWPORT NEWSVA2360201/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #10453 12755 JEFFERSON AVENUE
NEWPORT NEWSVA2360201/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.CVS PHARMACY # 16477 12130 JEFFERSON AVE
NEWPORT NEWSVA2360201/10/201704/01/2017  01/10/2017
Contract DetailVIRGINIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02338 700 MERRIMAC TRAIL
WILLIAMSBURGVA2318510/01/202101/01/2022  01/01/2022
Contract DetailWALGREEN CO.DBA: WALGREENS # 04446 3965 HOLLAND RD.
VIRGINIA BEACHVA2345211/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 04615 13007 WARWICK BLVD.
NEWPORT NEWSVA2360211/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 04617 919 W MERCURY BLVD
HAMPTONVA2366611/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 04924 2232 E. LITTLE CREEK RD.
NORFOLKVA2351811/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 05175 600 J CLYDE MORRIS BLVD
NEWPORT NEWSVA2360111/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 05588 9976 JEFFERSON AVE.
NEWPORT NEWSVA2360511/25/201111/25/2011 11/06/202411/12/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 05876 115 W LITTLE CREEK RD
NORFOLKVA2350511/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 05878 3326 W MERCURY BLVD
HAMPTONVA2366611/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 06633 2044 LYNNHAVEN PARKWAY
VIRGINIA BEACHVA23456-140911/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 06634 1857 CENTERVILLE TURNPIKE
VIRGINIA BEACHVA23464-652311/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 06790 3376 VIRGINIA BEACH BLVD
VIRGINIA BEACHVA23452-562011/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 06923 12750 JEFFERSON AVE
NEWPORT NEWSVA23602-431811/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 07240 235 E MERCURY BLVD
HAMPTONVA23669-245811/25/201111/25/2011 03/10/202003/10/2020
Contract DetailWALGREEN CO.DBA: WALGREENS # 07588 1169 N MILITARY HWY
NORFOLKVA2350211/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 09158 5305 INDIAN RIVER RD
VIRGINIA BEACHVA23464-532011/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #09811 6608 GEORGE WASHINGTON MEMORIAL HWY.
YORKTOWNVA2369211/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 09975 1309 RICHMOND RD
WILLIAMSBURGVA23185-283211/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #10140 14440 WARWICK BLVD.
NEWPORT NEWSVA2360811/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #10453 2400 GEORGE WASHINGTON MEMORIAL HWY.
YORKTOWNVA2369311/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #11298 2418 GEORGE WASHINGTON MEMORIAL HWY.
HAYESVA2307211/25/201111/25/2011  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #12032 3364 PRINCESS ANNE RD STE 501
RETAIL W 		VIRGINIA BEACHVA2345611/25/201111/25/2011 05/19/201508/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #10332 3633 BRIDGE RD.
SUFFOLKVA23435-180710/19/201501/01/2016  08/19/2016
Contract DetailWALGREEN CO.DBA: WALGREENS #11572 500 SETTLERS LANDING RD.
HAMPTONVA2366910/19/201501/01/2016  08/19/2016
Contract DetailWalgreens #21420Walgreens Central Fill #21420 8440 Times Dispatch Blvd
Ste. 400 		MechanicsvilleVA2311607/12/202310/01/2023  10/01/2023
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/06/202004/01/2020  04/01/2020
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/06/202004/01/2020  04/01/2020
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700801/06/202004/01/2020 10/01/202110/01/2021
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/06/202004/01/2020  04/01/2020
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH490052AChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Gastroenterology Specialists101 PHILLIP ROTH STREETNEWPORT NEWSVAActive
DSH490052AAChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Peninsula Surgery Center12000 Warwick BlvdNewport NewsVAActive
DSH490052ABChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Vascular Specialists500 J Clyde Morris BlvdNewport NewsVAActive
DSH490052ACChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Thoracic and Cardiovascular Surgery500 J Clyde Morris BlvdNewport NewsVAActive
DSH490052ADChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Cardiology Specialists Newport News500 J Clyde Morris BlvdNewport NewsVAActive
DSH490052AEChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Cardiology Specialists Gloucester7547 Medical DriveGloucesterVATerminated
DSH490052AFChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Vascular Specialists120 Kings Way, Suite 2600WilliamsburgVATerminated
DSH490052AGChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Cardiology Specialists Hampton850 Enterprise Parkway, Suite 1300HamptonVAActive
DSH490052AHChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Cardiology Specialists Williamsburg117 Bulifants BoulevardWilliamsburgVAActive
DSH490052AJChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Cardiology Specialists Newport News11803 Jefferson AvenueNewport NewsVAActive
DSH490052AKChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Doctors Surgery Center120 Kings WayWilliamsburgVAActive
DSH490052ALChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE PULMONARY AND SLEEP SPECI12200 WARWICK BLVD 290NEWPORT NEWSVATerminated
DSH490052AMChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE RHEUMATOLOGY SPECIALISTS850 Enterprise ParkwayHamptonVAActive
DSH490052ANChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS ENDOCRINOLOGY & DIABETES SPECIA120 KINGS WAYWILLIAMSBURGVATerminated
DSH490052APChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS PAIN MGMT AND REHAB SPECIALISTS7570 MEDICAL DRGLOUCESTERVATerminated
DSH490052AQChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE RENAL SPECIALISTS7552 HOSPITAL DRGLOUCESTERVATerminated
DSH490052ARChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE ORTHOPEDIC SPECIALISTS120 KINGS WAYWILLIAMSBURGVATerminated
DSH490052ASChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE VASCULAR SPECIALISTS7570 MEDICAL DRGLOUCESTERVATerminated
DSH490052ATChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE ORTHOPEDIC SPECIALISTS850 ENTERPRISE PKWY 2000HAMPTONVATerminated
DSH490052AUChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE WEIGHT LOSS SPECIALISTS850 ENTERPRISE PKWYHAMPTONVATerminated
DSH490052AVChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE RENAL SPECIALISTS739 THIMBLE SHOALS BLVDNEWPORT NEWSVAActive
DSH490052AWChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS ORTHO, SPORTS MED & PHYSIATRY12200 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052AXChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS ENDOCRINOLOGY & DIABETES SPECIA12200 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052AYChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS PAIN MGMT & REHAB SPECIALISTS850 Enterprise Parkway, Suite 2000HamptonVATerminated
DSH490052AZChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE HPT RDS NEURO & SPINE SPE12200 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052BChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE HAMPTON SURGERY CENTER850 ENTERPRISE PARKWAY, SUITE 1000HAMPTONVAActive
DSH490052BAChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE HPT RDS NEURO & SPINE SPE120 KINGS WAYWILLIAMSBURGVAActive
DSH490052BBChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE SURGICAL SPECIALISTS109 PHILIP ROTH STNEWPORT NEWSVAActive
DSH490052BCChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE GASTROENTEROLOGY SPECIALI120 Kings WayWILLIAMSBURGVAActive
DSH490052BDChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS EAR, NOSE & THROAT PHYS & SURGE120 KINGS WAYWILLIAMSBURGVAActive
DSH490052BEChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS YORK RIVER ORTHO & SPORTS MED7584 HOSPITAL DRIVEGLOUCESTERVATerminated
DSH490052BFChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE UROLOGY SPECIALISTS7552 HOSPITAL DRGLOUCESTERVATerminated
DSH490052BGChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE ORTHOPEDIC SPECIALISTS7544 HOSPITAL DRGLOUCESTERVATerminated
DSH490052BHChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE SURGICAL SPECIALISTS7554 HOSPITAL DRGLOUCESTERVATerminated
DSH490052BJChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE GASTROENTEROLOGY SPECIALI7547 MEDICAL DRGLOUCESTERVAActive
DSH490052BKChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS EAR, NOSE & THROAT PHYS & SURGE7570 HOSPITAL DRIVEGLOUCESTERVATerminated
DSH490052BLChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS EAR, NOSE & THROAT PHYS & SURGE895 City Center BlvdNEWPORT NEWSVAActive
DSH490052BMChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS PARTNERS IN WOMEN'S HEALT ONC12100 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052BNChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE NEUROVASCULAR SPECIALISTS12200 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052BPChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE SURGICAL SPECIALISTS120 KINGS WAYWILLIAMSBURGVATerminated
DSH490052BQChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRVS Pain Mgmt Specs / Pain Management120 Kings WayWilliamsburgVAActive
DSH490052BRChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Plastic and Reconstructive Surgery Specialists109 Philip Roth StreetNewport NewsVAActive
DSH490052BSChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Surgery Spec Plastic Surgery and Reconstructive / Plastic Surgery7554 Hospital DriveGloucesterVATerminated
DSH490052BTChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Urology Specialists - Urology850 Enterprise ParkwayHamptonVAActive
DSH490052BUChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Rheumatology Specialist - Rheumatology120 Kings WayWilliamsburgVAActive
DSH490052BVChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Gastroenterology Specialists - Gastroenterology850 Enterprise ParkwayHamptonVAActive
DSH490052BWChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Gastroenterology Specialists - Gastroenterology12200 Warwick BlvdNewport NewsVATerminated
DSH490052BXChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Williamsburg Infusion Center - Ambulatory Infusion120 Kings WayWilliamsburgVAActive
DSH490052BYChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Infectious Disease Assoc - Infectious Disease12420 Warwick BlvdNewport NewsVAActive
DSH490052BZChildDSHRIVERSIDE REGIONAL MEDICAL CENTEROrthoConnect - Orthopedics12200 Warwick BlvdNewport NewsVAActive
DSH490052CChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Orthopedic, Sports Medicine and Physiatry Specialists12420 WARWICK BOULEVARDNEWPORT NEWSVATerminated
DSH490052CAChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE MENTAL HLTH AND REC CTR - Addiction Intensive Outpatient Program2244 EXECUTIVE DRHAMPTONVAActive
DSH490052CBChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE MENTAL HLTH AND REC CTR - Addiction Partial Hospitalization Program2244 EXECUTIVE DRHAMPTONVAActive
DSH490052CCChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRENAL SPECIALISTS WILLIAMSBURG - Renal120 Kings WayWILLIAMSBURGVAActive
DSH490052CDChildDSHRIVERSIDE REGIONAL MEDICAL CENTERMental Health Outpatient Services - Mental Health2244 Executive DriveHAMPTONVAActive
DSH490052CEChildDSHRIVERSIDE REGIONAL MEDICAL CENTERMental Health Intensive Outpatient Program - Mental Health2244 Executive DriveHAMPTONVAActive
DSH490052CFChildDSHRIVERSIDE REGIONAL MEDICAL CENTERMental Health Partial Hospitalization Program - Mental Health2244 Executive DriveHamptonVAActive
DSH490052CGChildDSHRIVERSIDE REGIONAL MEDICAL CENTERHAMPTON INFUSION CENTER - INFUSION850 Enterprise ParkwayHamptonVAActive
DSH490052DChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE CANCER INFUSION CENTER - WILLIAMSBURG120 KINGS WAYWILLIAMSBURGVAActive
DSH490052EChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE CANCER INFUSION CENTER - NEWPORT NEWS12100 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052FChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE CANCER INFUSION CENTER - GLOUCESTER7544 MEDICAL DRIVEGLOUCESTERVAActive
DSH490052GChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE CANCER INFUSION CENTER - CHESAPEAKE110 WIMBLEDON SQUARECHESAPEAKEVAActive
DSH490052HChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE CANCER INFUSION CENTER - VIRGINIA BEACH1200 First Colonial RoadVirginia BeachVAActive
DSH490052JChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Neurology Specialists12200 WARWICK BLVDNEWPORT NEWSVAActive
DSH490052KChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRIVERSIDE CANCER INFUSION CENTER - SUFFOLK5839 Harbour View BlvdSUFFOLKVAActive
DSH490052LChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Hospital Inc dba Riverside Hospice12420 Warwick BlvdNewport NewsVATerminated
DSH490052MChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Diagnostic and Breast Imaging Center895 City Center BlvdNewport NewsVAActive
DSH490052NChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Diagnostic Center Williamsburg120 Kings WayWilliamsburgVAActive
DSH490052PChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Diagnostic Center Smithfield202 Gumwood DriveSmithfieldVAActive
DSH490052QChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Diagnostic Center Hampton850 Enterprise ParkwayHamptonVAActive
DSH490052RChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Diabetes Center12200 Warwick BlvdNewport NewsVAActive
DSH490052SChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Pulmonary and Sleep Center12200 Warwick BlvdNewport NewsVAActive
DSH490052TChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Urology Specialists120 Kings WayWilliamsburgVAActive
DSH490052UChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Urology Specialists500 J Clyde Morris BlvdNewport NewsVAActive
DSH490052VChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Pulmonary and Sleep Specialists120 Kings WayWilliamsburgVAActive
DSH490052WChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Neurology and Sleep Specialists12200 Warwick BlvdNewport NewsVATerminated
DSH490052XChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Neurology and Sleep Specialists7547 Medical DriveGloucesterVAActive
DSH490052YChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Neurology and Sleep Specialists120 Kings WayWilliamsburgVAActive
DSH490052ZChildDSHRIVERSIDE REGIONAL MEDICAL CENTERRiverside Neurology Specialists850 Enterprise ParkwayHamptonVAActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
Medicaid BillingMedicaid: NumberDeleteChange Request1053041061 (VA) 10/11/2024 8:31 AM
Medicaid BillingNPI: NumberDeleteChange Request1053041061 (VA) 10/11/2024 8:31 AM
DetailsLast Recertification DateUpdateRecertification8/24/2023 10:57:17 AM8/16/2024 1:33:08 PM8/16/2024 1:33 PM
ContactsPrimary ContactUpdateProfile Change RequestWilliams, Cynthia VP/Chief Pharmacy Officer Riverside Health System 7573165707Williams, Cynthia VP/Chief Pharmacy Officer Riverside Health System 75778415697/12/2024 10:05 AM
AddressesMain AddressUpdateChange Request 500 J. CLYDE MORRIS BLVD. NEWPORT NEWS, VA 23601 500 J Clyde Morris Blvd NEWPORT NEWS, VA 236014/25/2024 1:37 PM
AddressesShipping AddressInsertChange Request Riverside Hospital Inc dba Riverside Regional Medical Center Central Pharmacy Distribution 11832 Rock Landing Drive 402 Newport News, VA 236064/25/2024 1:37 PM
DetailsLast Recertification DateUpdateRecertification9/16/2022 9:54:37 AM8/24/2023 10:57:17 AM8/24/2023 10:57 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/3/2023 8:31 AM
Medicaid BillingMedicaid: NumberInsertChange Request 10530410611/3/2023 8:31 AM
Medicaid BillingMedicaid: StateInsertChange Request VA1/3/2023 8:31 AM
Medicaid BillingNPI: NumberInsertChange Request 10530410611/3/2023 8:31 AM
Medicaid BillingNPI: StateInsertChange Request VA1/3/2023 8:31 AM
AddressesShipping AddressUpdateChange RequestRiverside Hospital Inc dba Riverside Pharmacy Chesapeake 110 Wimbledon Square Chesapeake, VA 23320Riverside Hospital Inc dba Riverside Pharmacy Chesapeake 110 Wimbledon Square Suite B Chesapeake, VA 2332010/26/2022 7:50 AM
AddressesShipping AddressInsertChange Request Riverside Hospital Inc dba Riverside Pharmacy Chesapeake 110 Wimbledon Square Chesapeake, VA 233209/19/2022 2:07 PM
DetailsLast Recertification DateUpdateRecertification9/10/2021 1:44:01 PM9/16/2022 9:54:37 AM9/16/2022 9:54 AM
AddressesShipping AddressInsertChange Request Pavilion Pharmacy 500 J Clyde Morris Blvd Room 1-501 Newport News, VA 236017/27/2022 6:49 AM
AddressesShipping AddressInsertChange Request Inpatient Pharmacy 500 J Clyde Morris Blvd Newport News, VA 236017/27/2022 6:49 AM
DetailsLast Recertification DateUpdateRecertification8/27/2020 9:34:43 AM9/10/2021 1:44:01 PM9/10/2021 1:44 PM
Medicaid BillingNPI: NumberInsertRecertification 13665477478/27/2020 9:34 AM
Medicaid BillingNPI: StateInsertRecertification VA8/27/2020 9:34 AM
Medicaid BillingNPI: NumberDeleteRecertification1366547747 ( ) 8/27/2020 9:34 AM
DetailsLast Recertification DateUpdateRecertification9/15/2019 2:24:30 PM8/27/2020 9:34:43 AM8/27/2020 9:34 AM
DetailsLast Recertification DateUpdateRecertification9/7/2018 12:32:59 PM9/15/2019 2:24:30 PM9/15/2019 2:24 PM
DetailsLast Recertification DateUpdateRecertification11/30/2017 11:33:11 AM9/7/2018 12:32:59 PM9/7/2018 12:32 PM
DetailsLast Recertification DateUpdateRecertification8/16/2016 12:00:00 AM11/30/2017 11:33:11 AM11/30/2017 11:33 AM
ContactsPrimary ContactUpdate Williams, Cynthia VP/Chief Pharmacy Officer 7573165707Williams, Cynthia VP/Chief Pharmacy Officer Riverside Health System 757316570710/13/2017 11:52 AM
ContactsAuthorizing OfficialUpdate AUSTIN JR., WILLIAM W. SENIOR VP & CFO 7575347015AUSTIN JR., WILLIAM W. SENIOR VP & CFO Riverside Healthcare Association Inc 757534701510/11/2017 10:46 AM
ContactsAuthorizing OfficialInsert  AUSTIN JR., WILLIAM W. SENIOR VP & CFO 75753470157/13/2017 3:59 PM
ContactsPrimary ContactInsert  Williams, Cynthia VP/Chief Pharmacy Officer 75731657076/26/2017 10:16 AM
AddressesMain AddressInsert   500 J. CLYDE MORRIS BLVD. NEWPORT NEWS, VA 236018/19/2016 4:25 PM
DetailsLast Recertification DateUpdate 8/16/2015 12:00:00 AM8/16/2016 12:00:00 AM8/16/2016 11:29 AM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse8/25/2015 5:10 AM
Medicaid BillingNPI: NumberInsert  13665477478/25/2015 5:10 AM
DetailsLast Recertification DateUpdate 8/29/2014 12:00:00 AM8/16/2015 12:00:00 AM8/25/2015 5:10 AM
DetailsLast Recertification DateUpdate 9/9/2013 12:00:00 AM8/29/2014 12:00:00 AM8/29/2014 9:58 AM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM9/9/2013 12:00:00 AM9/9/2013 10:00 PM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM5/7/2012 8:57 AM
DetailsLast Recertification DateInsert   6/10/2008 1:05 PM
DetailsGrant NumberInsert   6/10/2008 1:05 PM
Details340B IDInsert  DSH4900526/10/2008 1:05 PM
DetailsIs Authorizing Official EHB DataInsert   6/10/2008 1:05 PM
DatesLast Date That 340B Drugs PurchasedInsert   6/10/2008 1:05 PM
DetailsMedicare Provider NumberInsert  4900526/10/2008 1:05 PM
DetailsEntity NameInsert  RIVERSIDE REGIONAL MEDICAL CENTER6/10/2008 1:05 PM
DetailsProgram CodeInsert  DSH6/10/2008 1:05 PM
DetailsEntity SubnameInsert   6/10/2008 1:05 PM
DatesParticipating Approval DateInsert  6/10/2008 12:00:00 AM6/10/2008 1:05 PM
DetailsStateInsert  Active6/10/2008 1:05 PM
DatesRegistration DateInsert  6/10/2008 12:00:00 AM6/10/2008 1:05 PM
DatesSigned By DateInsert  5/30/2008 12:00:00 AM6/10/2008 1:05 PM
DatesStart DateInsert  7/1/2008 12:00:00 AM6/10/2008 1:05 PM
TerminationsTermination CommentsInsert   6/10/2008 1:05 PM
TerminationsTermination DateInsert   6/10/2008 1:05 PM
TerminationsTermination Effective DateInsert   6/10/2008 1:05 PM
TerminationsTermination ReasonInsert   6/10/2008 1:05 PM
Medicaid BillingMedicaid: Is PrimaryInsert  True6/10/2008 12:59 PM
Medicaid BillingMedicaid: NumberInsert  49005296/10/2008 12:59 PM
Medicaid BillingMedicaid: StateInsert  VA6/10/2008 12:59 PM