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DSH410007Z RHODE ISLAND HOSPITAL (Terminated)
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Main Details
Name
RHODE ISLAND HOSPITAL
Subdivision Name
Wayland Square Surgical Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410007Z
Medicare Provider Number
410007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/7/2015
Last Recertification Date
9/7/2022
Termination Date
Termination Reason
4/1/2023
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Lifespan
Eva Greenwood, Senior VP Finance
(401) 444-2221
Primary Contact
Brown University Health
CHRISTINE COLLINS, SVP, Pharmacy & Periop, Chief Pharmacy Officer
(401) 444-4434
Addresses
Street Address
17 Seekonk St
Providence, RI 02906
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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