340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH490017R Maryview Hospital LLC (Terminated)
Print
Main Details
Name
Maryview Hospital LLC
Subdivision Name
Harbour View Emergency Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490017R
Medicare Provider Number
490017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/22/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/6/2013
Last Recertification Date
8/23/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
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
5818D Harbour View Blvd.
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.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
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