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DSH490032K Virginia Commonwealth University Health System (Terminated)
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Main Details
Name
Virginia Commonwealth University Health System
Subdivision Name
VCU Health System Stony Point
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490032K
Medicare Provider Number
490032
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/5/2014
Last Recertification Date
8/30/2016
Termination Date
Termination Reason
4/1/2017
Site closure
Contacts
Authorizing Official
VCU Health System
Paul Wesolowski, Chief Operating Officer
(804) 828-4607
Primary Contact
VCU Health System
Rodney Stiltner, Director of Pharmacy
(804) 828-5468
Addresses
Street Address
9000 Stony Point Parkway
Richmond, VA 23235
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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