340B Drug Pricing Program Database
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DSH490024AV CARILION MEDICAL CENTER (Active)
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Main Details
Name
CARILION MEDICAL CENTER
Subdivision Name
Carilion Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490024AV
Medicare Provider Number
490024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/4/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/2/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Carilion Clinic
Tim Auwarter, VP Hospital Operations
(540) 981-7804
Primary Contact
Carilion
Trina Epperly, 340B Program Director
(540) 224-3004
Addresses
Street Address
1 RIVERSIDE CIRCLE
Suite 300M
ROANOKE, VA 24016
Billing Address
Carilion Roanoke Memorial Hospital
1906 Belleview Ave SE
Roanoke, VA 24014
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Last recertification Date 09/28/2020
09/28/2020
May 2025
May 2025
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