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DSH490009CG UNIVERSITY OF VIRGINIA MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF VIRGINIA MEDICAL CENTER
Subdivision Name
Repro-Endo-Northridge - 2796
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490009CG
Medicare Provider Number
490009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
Last Recertification Date
8/16/2021
Termination Date
Termination Reason
7/1/2022
Site closure
Contacts
Authorizing Official
UVA Health System
Brian Wilmoth, Strategic Planning and Reimbursement Officer
(434) 243-9802
Primary Contact
UVA Health System
Danielle Griggs, Pharmacy Director, Business Services
(434) 297-5582
Addresses
Street Address
2955 Ivy Rd.
Charlottesville, VA 22903
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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