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DSH490022W MARY WASHINGTON HOSPITAL (Active)
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Main Details
Name
MARY WASHINGTON HOSPITAL
Subdivision Name
MW PT PLANK RD - Physical Therapy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490022W
Medicare Provider Number
490022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/10/2024
Last Recertification Date
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
4900 Plank Road
102
Fredericksburg, VA 22407
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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