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DSH410007AC RHODE ISLAND HOSPITAL (Active)
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Main Details
Name
RHODE ISLAND HOSPITAL
Subdivision Name
RIH East Providence Infusion Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410007AC
Medicare Provider Number
410007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/6/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/10/2017
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Brown University Health
Michael D Dawson, VP Finance
(401) 444-2648
Primary Contact
Brown University Health
CHRISTINE COLLINS, SVP, Pharmacy & Periop, Chief Pharmacy Officer
(401) 444-4434
Addresses
Street Address
375 Wampanoag Trail
Suite 101A
East Providence, RI 02915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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