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DSH410007U RHODE ISLAND HOSPITAL (Terminated)
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Main Details
Name
RHODE ISLAND HOSPITAL
Subdivision Name
Child Protection Clinic (Hasbro)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410007U
Medicare Provider Number
410007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/6/2015
Last Recertification Date
8/28/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
Rhode Island Hospital
Mary Wakefield, Senior VP and CFO
(401) 444-7093
Primary Contact
Rhode Island Hospital
Mary Wakefield, Senior VP and CFO
(401) 444-7093
Addresses
Street Address
1 Hoppin St., Rm 3055
Providence, RI 02903
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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