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SCH490013-00 SENTARA HALIFAX REGIONAL HOSPITAL (Active)
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Main Details
Name
SENTARA HALIFAX REGIONAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH490013-00
Medicare Provider Number
490013
Additional Details
Current Program Status
Active
Registration Date
7/19/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/7/2023
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Sentara Halifax Regional Hospital
Brian Keith Zwoyer, President
(434) 517-3196
Primary Contact
Sentara Halifax Regional Hospital
David Bryant Fitts, Pharmacy Manager
(434) 517-3312
Addresses
Street Address
2204 WILBORN AVENUE
SOUTH BOSTON, VA 24592
Billing Address
Sentara Halifax Regional Hospital
1300 Sentara Park
Virginia Beach, VA 23464
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/28/2021, terminated 3/15/2022. Reinstated 10/1/2023.
08/07/2023
Participated starting 10/1/2017, terminated 7/1/2019, Reinstated 1/1/2020.
10/18/2019
7/31/17 Participating as SCH from effective date (10/1/2013), until terminated effective date (10/1/2016), participated as DSH from 10/01/2016 to 07/01/2017, reinstated as SCH effective (10/01/2017)
07/31/2017
April 2025
April 2025
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