Covered Entity Details

SCH490004-05 SENTARA RMH MEDICAL CENTER (Active) - information as of 6/16/2025 11:17:02 PM

Main Details

Name

SENTARA RMH MEDICAL CENTER

Subdivision Name

Sentara Advanced Imaging Center - Clinic

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH490004-05

Medicare Provider Number

490004

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/13/2023

Participating Start Date

10/1/2023

Participating Approval Date

9/4/2023

Last Recertification Date

8/15/2024

Contacts

Authorizing Official

Sentara RMH Medical Center
Douglas Moyer, President
(540) 689-1251

Primary Contact

Sentara RMH Medical Center
Laura Adkins, Pharmacy Manager
(540) 689-2374

Addresses

Street Address

2509 Pleasant Run Drive
Harrisonburg, VA 22801

Billing Address

Sentara RMH Medical Center
1300 Sentara Park
Virginia Beach, VA 23464

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
SCH490004-01	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara Rheumatology Specialists - Clinic	2509 Pleasant Run Drive	Harrisonburg	VA	Active
SCH490004-02	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara Neurology Specialists - Clinic	2006 Health Campus Drive	Harrisonburg	VA	Active
SCH490004-03	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara Hematology and Oncology Associates - Clinic	2008 Health Campus Drive	Harrisonburg	VA	Active
SCH490004-04	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara Pulmonology and Critical Care Specialists - Clinic	2006 Health Campus Drive	Harrisonburg	VA	Active
SCH490004-05	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara Advanced Imaging Center - Clinic	2509 Pleasant Run Drive	Harrisonburg	VA	Active
SCH490004-06	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara Cardiology Specialists - Clinic	2006 Health Campus Drive	Harrisonburg	VA	Active
SCH490004-07	Child	SCH	SENTARA RMH MEDICAL CENTER	Sentara RMH Infusion - Oncology and Treatment Center	2006 Health Campus Drive	Harrisonburg	VA	Terminated
SCH490004-08	Child	SCH	SENTARA RMH MEDICAL CENTER	SRMG INFECTIOUS DISEASE - Infectious Disease Clinic	2006 HEALTH CAMPUS DR	ROCKINGHAM	VA	Active
SCH490004-09	Child	SCH	SENTARA RMH MEDICAL CENTER	SRMG ORTHOPEDICS AND SPORTS MED - Ortho Clinic	2509 PLEASANT RUN DR	HARRISONBURG	VA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Billing Address	Update	Group Change Request	Sentara RMH Medical Center 6015 Poplar Hall Drive Norfolk, VA 23502	Sentara RMH Medical Center 1300 Sentara Park Virginia Beach, VA 23464	9/11/2024 3:01 PM
Details	Last Recertification Date	Update	Recertification		8/15/2024 1:28:38 PM	8/15/2024 1:28 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1841203452 (NC)		1/12/2024 2:43 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1841203452 (VA)		1/12/2024 2:43 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1841203452 (WV)		1/12/2024 2:43 PM
Medicaid Billing	Medicaid: Number	Delete	Group Change Request	49-0004-00 (NC)		12/18/2023 3:13 PM
Medicaid Billing	Medicaid: Number	Delete	Group Change Request	49-0004-00 (VA)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1669844908 (NC)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1851301444 (NC)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1780694372 (NC)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1669844908 (VA)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1851301444 (VA)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1780694372 (VA)		12/18/2023 3:13 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1841203452	12/18/2023 3:13 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		WV	12/18/2023 3:13 PM
Details	State	Update		Approved	Active	10/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Moyer, Douglas President Sentara RMH Medical Center 5406891251	9/4/2023 12:21 AM
Details	340B ID	Update	New Registration		SCH490004-05	9/4/2023 12:21 AM
Details	Entity Subname	Update	New Registration	Sentara Advanced Imaging Center	Sentara Advanced Imaging Center - Clinic	9/4/2023 12:21 AM
Dates	Participating Approval Date	Update	New Registration		9/4/2023 12:21:45 AM	9/4/2023 12:21 AM
Details	State	Update	New Registration	Pending	Approved	9/4/2023 12:21 AM
Dates	Signed By Date	Update	New Registration		7/24/2023 8:55:33 AM	9/4/2023 12:21 AM
Dates	Start Date	Update	New Registration		10/1/2023 12:00:00 AM	9/4/2023 12:21 AM
Addresses	Main Address	Insert	New Registration		2509 Pleasant Run Drive Harrisonburg, VA 22801	7/13/2023 2:45 PM
Addresses	Billing Address	Insert	New Registration		Sentara RMH Medical Center 6015 Poplar Hall Drive Norfolk, VA 23502	7/13/2023 2:45 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/13/2023 2:45 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		49-0004-00	7/13/2023 2:45 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NC	7/13/2023 2:45 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/13/2023 2:45 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		49-0004-00	7/13/2023 2:45 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		VA	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1669844908	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1841203452	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851301444	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1780694372	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		NC	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1669844908	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		VA	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1841203452	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		VA	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1851301444	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		VA	7/13/2023 2:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1780694372	7/13/2023 2:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		VA	7/13/2023 2:45 PM
Contacts	Authorizing Official	Insert	New Registration		Moyer, Douglas President Sentara RMH Medical Center 5406891251	7/13/2023 2:45 PM
Contacts	Primary Contact	Insert	New Registration		Adkins, Laura Pharmacy Manager Sentara RMH Medical Center 5406892374	7/13/2023 2:45 PM
Details	Assistance Received From Date	Insert	New Registration			7/13/2023 2:45 PM
Details	Assistance Received To Date	Insert	New Registration			7/13/2023 2:45 PM
Details	Last Recertification Date	Insert	New Registration			7/13/2023 2:45 PM
Details	Grant Number	Insert	New Registration			7/13/2023 2:45 PM
Details	340B ID	Insert	New Registration			7/13/2023 2:45 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/13/2023 2:45 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/13/2023 2:45 PM
Details	Medicare Provider Number	Insert	New Registration		490004	7/13/2023 2:45 PM
Details	Entity Name	Insert	New Registration		SENTARA RMH MEDICAL CENTER	7/13/2023 2:45 PM
Details	NOFO Number	Insert	New Registration			7/13/2023 2:45 PM
Details	Program Code	Insert	New Registration		SCH	7/13/2023 2:45 PM
Details	Entity Subname	Insert	New Registration		Sentara Advanced Imaging Center	7/13/2023 2:45 PM
Dates	Participating Approval Date	Insert	New Registration			7/13/2023 2:45 PM
Details	State	Insert	New Registration		Pending	7/13/2023 2:45 PM
Dates	Registration Date	Insert	New Registration		7/13/2023 2:45:32 PM	7/13/2023 2:45 PM
Dates	Signed By Date	Insert	New Registration			7/13/2023 2:45 PM
Dates	Start Date	Insert	New Registration			7/13/2023 2:45 PM
Terminations	Termination Comments	Insert	New Registration			7/13/2023 2:45 PM
Terminations	Termination Date	Insert	New Registration			7/13/2023 2:45 PM
Terminations	Termination Effective Date	Insert	New Registration			7/13/2023 2:45 PM
Terminations	Termination Reason	Insert	New Registration			7/13/2023 2:45 PM