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DSH410007J RHODE ISLAND HOSPITAL (Terminated)
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Main Details
Name
RHODE ISLAND HOSPITAL
Subdivision Name
Electrocardiology Lab ( Stress Lab )
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410007J
Medicare Provider Number
410007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/20/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/10/2012
Last Recertification Date
8/31/2018
Termination Date
Termination Reason
4/1/2019
Other
Contacts
Authorizing Official
Rhode Island Hospital
Mary Wakefield, Senior VP and CFO
(401) 444-7093
Primary Contact
Brown University Health
CHRISTINE COLLINS, SVP, Pharmacy & Periop, Chief Pharmacy Officer
(401) 444-4434
Addresses
Street Address
1 Hoppin Street
Suite 304
Providence, RI 02903
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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