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DSH490059 BON SECOURS - ST. MARYS HOSPITAL (Active)
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Main Details
Name
BON SECOURS - ST. MARYS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490059
Medicare Provider Number
490059
Additional Details
Current Program Status
Active
Registration Date
7/2/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/12/2024
Last Recertification Date
Contacts
Authorizing Official
Bon Secours Mercy Health
Gregory S Simmons, Site CFO
(804) 248-8731
Primary Contact
Bon Secours - St. Mary's Hospital
Caroline Briggs, Director of Pharmacy
(804) 287-7807
Addresses
Street Address
5801 BREMO ROAD
RICHMOND, VA 23226
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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