340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH490017D BON SECOURS MARYVIEW MEDICAL CENTER (Terminated)
Print
Main Details
Name
BON SECOURS MARYVIEW MEDICAL CENTER
Subdivision Name
Internists of Churchland
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490017D
Medicare Provider Number
490017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/11/2013
Last Recertification Date
8/24/2023
Termination Date
Termination Reason
7/1/2024
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Bon Secours Mercy Health
Jonathan Lee Haynes, Hampton Roads Market CFO
(540) 270-2809
Primary Contact
Bon Secours Mercy Health
Diana Willman, Pharmacy Director
(757) 398-2192
Addresses
Street Address
7185 Harbour Towne Parkway S
Suite 206
Suffolk, VA 23435
Billing Address
Bon Secours Maryview Medical Center
3636 High Street
Portsmouth, VA 23707
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session