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DSH490052N RIVERSIDE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
RIVERSIDE REGIONAL MEDICAL CENTER
Subdivision Name
Riverside Diagnostic Center Williamsburg
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490052N
Medicare Provider Number
490052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/30/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/14/2011
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Riverside Healthcare Association Inc
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Primary Contact
Riverside Health Syhstem
Olukemi Olatunji, Sr. Director Acute Care Pharmacy
(757) 323-6950
Addresses
Street Address
120 Kings Way
Suite 1200
Williamsburg, VA 23185
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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