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DSH490022T MARY WASHINGTON HOSPITAL (Active)
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Main Details
Name
MARY WASHINGTON HOSPITAL
Subdivision Name
GME Internal Medicine - Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490022T
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
1201 Sam Perry Blvd
201
Fredericksburg, VA 22401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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