340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH490024L CARILION MEDICAL CENTER (Terminated)
Print
Main Details
Name
CARILION MEDICAL CENTER
Subdivision Name
INFERTILITY ENDOCRINE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490024L
Medicare Provider Number
490024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/4/2007
Participating Start Date
10/1/2007
Participating Approval Date
9/6/2007
Last Recertification Date
9/13/2022
Termination Date
Termination Reason
1/1/2023
Other
Contacts
Authorizing Official
Carilion Clinic
Tim Auwarter, VP Hospital Operations
(540) 981-7804
Primary Contact
Carilion
Trina Epperly, 340B Program Director
(540) 224-3004
Addresses
Street Address
1231 South Jefferson St
DSH490024L
ROANOKE, VA 24016
Billing Address
Carilion Roanoke Memorial Hospital
1906 Belleview Ave SE
Roanoke, VA 24014
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
4/10/2014 - Multiple terminations/reinstatements recorded in error; site remained continuously eligible from participation start date. 9/26/08 ADDED SHIP TO; 7/31/08 DOC RECD CONFIRM ELIG DSH ADJ %
04/14/2014
7/31/08 DOC RECD CONFIRM ELIG DSH ADJ %
08/05/2008
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session