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DSH490052L RIVERSIDE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
RIVERSIDE REGIONAL MEDICAL CENTER
Subdivision Name
Riverside Hospital Inc dba Riverside Hospice
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490052L
Medicare Provider Number
490052
Outpatient Facility Provider Number
491509
Additional Details
Current Program Status
Terminated
Registration Date
11/29/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/19/2011
Last Recertification Date
9/2/2021
Termination Date
Termination Reason
4/1/2022
Never implemented the 340B Program
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
12420 Warwick Blvd
Suite 6E
Newport News, VA 23606
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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