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DSH490094A RICHMOND COMMUNITY HOSPITAL (Active)
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Main Details
Name
RICHMOND COMMUNITY HOSPITAL
Subdivision Name
Bremo Outpatient Infusion Center SO
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490094A
Medicare Provider Number
490094
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/1/2006
Participating Start Date
4/1/2005
Participating Approval Date
6/5/2006
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Bon Secours Mercy Health
Gregory S Simmons, Site CFO
(804) 248-8731
Primary Contact
Richmond Community Hospital
DeJuan Branch, Director of Pharmacy
(804) 343-6407
Addresses
Street Address
5875 BREMO RD
STE G6
RICHMOND, VA 23226
Billing Address
Bon Secours Richmond Community Hospital
1500 North 28th Street
Richmond, VA 23223
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/5/06 - REPLACES DSH23223A
01/04/2007
June 2025
June 2025
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