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DSH490022N MARY WASHINGTON HOSPITAL (Active)
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Main Details
Name
MARY WASHINGTON HOSPITAL
Subdivision Name
MWH REHAB SVCS OP - OP rehab/PT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490022N
Medicare Provider Number
490022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/11/2024
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Mary Washington Healthcare
Sean Timothy Barden, Executive VP & CFO
(540) 741-1494
Primary Contact
Mary Washington Hospital
John Michael Coggins, Director of Pharmacy
(540) 741-7525
Addresses
Street Address
1201 Sam Perry Blvd, Suite 240
Fredericksburg, VA 22401
Billing Address
Mary Washington Hospital
2300 Fall Hill Avenue, Suite 313
Fredericksburg, VA 22401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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