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DSH490009AA UNIVERSITY OF VIRGINIA MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF VIRGINIA MEDICAL CENTER
Subdivision Name
Endocrine Clinic 2735
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490009AA
Medicare Provider Number
490009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/1/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/3/2012
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
UVA Health System
Brian Wilmoth, Strategic Planning and Reimbursement Officer
(434) 243-9802
Primary Contact
UVA Health System
Jordan T DeAngelis, Director Pharmacy
(434) 982-1950
Addresses
Street Address
415 Ray C. Hunt Drive
Charlottesville, VA 22903
Billing Address
UVA Health System
1215 Lee Street
Charlottesville, VA 22908
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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