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DSH490052CF RIVERSIDE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
RIVERSIDE REGIONAL MEDICAL CENTER
Subdivision Name
Mental Health Partial Hospitalization Program - Mental Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490052CF
Medicare Provider Number
490052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2024
Participating Start Date
1/1/2025
Participating Approval Date
11/5/2024
Last Recertification Date
Contacts
Authorizing Official
Riverside Healthcare Association Inc
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Primary Contact
Riverside Health System
Cynthia Williams, VP/Chief Pharmacy Officer
(757) 784-1569
Addresses
Street Address
2244 Executive Drive
Hampton, VA 23666
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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