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DSH490037K RIVERSIDE SHORE MEMORIAL HOSPITAL (Active)
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Main Details
Name
RIVERSIDE SHORE MEMORIAL HOSPITAL
Subdivision Name
Riverside Eastern Shore Physicians and Surgeons - Neurology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490037K
Medicare Provider Number
490037
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/9/2019
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Riverside Healthcare Association Inc
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Primary Contact
Riverside Health System
Cynthia Williams, VP/Chief Pharmacy Officer
(757) 784-1569
Addresses
Street Address
20486 Market Street
Onancock, VA 23417
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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