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DSH050292C Riverside University Health System (Active)
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Main Details
Name
Riverside University Health System
Subdivision Name
MH ER Treatment Facility/ETS (Behavioral Health/Mental Health)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050292C
Medicare Provider Number
050292
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/26/2013
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
RUHS
Leah Patterson, Chief Nursing Officer
(951) 486-7532
Primary Contact
RUHS
Davalyn Tidwell, Pharmacy Director
(951) 486-4527
Addresses
Street Address
9990 County Farm Road
Suite 4
Riverside, CA 92503
Billing Address
Riverside University Health System
26520 Cactus Avenue
Moreno Valley, CA 92555
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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