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DSH490052AK RIVERSIDE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
RIVERSIDE REGIONAL MEDICAL CENTER
Subdivision Name
Riverside Doctors Surgery Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490052AK
Medicare Provider Number
490052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/25/2014
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Riverside Healthcare Association Inc
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Primary Contact
Riverside Health Syhstem
Olukemi Olatunji, Sr. Director Acute Care Pharmacy
(757) 323-6950
Addresses
Street Address
120 Kings Way
Sutie 1500
Williamsburg, VA 23185
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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