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DSH490032HC Virginia Commonwealth University Health System (Terminated)
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Main Details
Name
Virginia Commonwealth University Health System
Subdivision Name
Virginia Commonwealth University Health System - Stony Point Non-Invasive Cardiology (1606)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490032HC
Medicare Provider Number
490032
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/27/2019
Last Recertification Date
8/23/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
VCU Health System
James Vincent Willis, VP Professional Services
(804) 628-3002
Primary Contact
VCU Health
Kevin D Payne, Pharmacist
(804) 364-6815
Addresses
Street Address
9000 Stony Point Parkway
2nd Floor
Richmond, VA 23235
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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