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DSH410007N RHODE ISLAND HOSPITAL (Active)
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Main Details
Name
RHODE ISLAND HOSPITAL
Subdivision Name
Medical Primary Care Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410007N
Medicare Provider Number
410007
Outpatient Facility Provider Number
410007
Additional Details
Current Program Status
Active
Registration Date
7/10/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/12/2013
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Brown University Health
Michael D Dawson, VP Finance
(401) 444-2648
Primary Contact
Brown University Health
CHRISTINE COLLINS, SVP, Pharmacy & Periop, Chief Pharmacy Officer
(401) 444-4434
Addresses
Street Address
245 Chapman Street
Suite 300
Providence, RI 02905
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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