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DSH490052BE RIVERSIDE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
RIVERSIDE REGIONAL MEDICAL CENTER
Subdivision Name
RVS YORK RIVER ORTHO & SPORTS MED
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH490052BE
Medicare Provider Number
490052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/12/2015
Last Recertification Date
8/16/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Riverside Healthcare Association Inc
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Primary Contact
Riverside Health System
Cynthia Williams, VP/Chief Pharmacy Officer
(757) 784-1569
Addresses
Street Address
7584 HOSPITAL DRIVE
BUILDING C SUITE 202
GLOUCESTER, VA 23061
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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