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DSH490009ED UNIVERSITY OF VIRGINIA MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF VIRGINIA MEDICAL CENTER
Subdivision Name
UVBB PEDS ECHO - 2211
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490009ED
Medicare Provider Number
490009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/1/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/4/2015
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
UVA Health System
Brian Wilmoth, Strategic Planning and Reimbursement Officer
(434) 243-9802
Primary Contact
UVA Health System
Jordan T DeAngelis, Director Pharmacy
(434) 982-1950
Addresses
Street Address
1204 West Main Street
Charlottesville, VA 22908
Billing Address
UVA Health System
1215 Lee Street
Charlottesville, VA 22908
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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