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DSH490032FV Virginia Commonwealth University Health System (Active)
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Main Details
Name
Virginia Commonwealth University Health System
Subdivision Name
Children's Pavilion - Pediatric Infectious Disease
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490032FV
Medicare Provider Number
490032
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/23/2018
Last Recertification Date
9/11/2024
Contacts
Authorizing Official
VCU Health System
Matthew Jenkins, Vice President, Chief Pharmacy Officer
(804) 628-8676
Primary Contact
VCU Health
Kevin D Payne, Pharmacist
(804) 364-6815
Addresses
Street Address
1000 East Broad Street
6th Floor Pod J
Richmond, VA 23219
Billing Address
VCU Health System Authority
1250 East Marshall Street
Richmond, VA 23298
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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