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DSH410007AV RHODE ISLAND HOSPITAL (Active)
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Main Details
Name
RHODE ISLAND HOSPITAL
Subdivision Name
Wound Care & Hyperbaric Center - Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH410007AV
Medicare Provider Number
410007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/29/2019
Last Recertification Date
8/21/2024
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
950 Warren Avenue
103
East Providence, RI 02914-1432
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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