340B Drug Pricing Program Database
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DSH490024EA CARILION MEDICAL CENTER (Active)
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Main Details
Name
CARILION MEDICAL CENTER
Subdivision Name
PSY BEH MED CHILD ADOL
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490024EA
Medicare Provider Number
490024
Outpatient Facility Provider Number
490024
Additional Details
Current Program Status
Active
Registration Date
7/9/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/3/2014
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
2017 S Jefferson St, 2nd Floor
1124024
Roanoke, VA 24014
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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