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DSH490024Q CARILION MEDICAL CENTER (Active)
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Main Details
Name
CARILION MEDICAL CENTER
Subdivision Name
BONE & JOINT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490024Q
Medicare Provider Number
490024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
9/4/2007
Participating Start Date
10/1/2007
Participating Approval Date
9/6/2007
Last Recertification Date
9/5/2024
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
3 Riverside Circle
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
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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
April 2025
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