340B Drug Pricing Program Database
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DSH050292P Riverside University Health System (Active)
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Main Details
Name
Riverside University Health System
Subdivision Name
RUHS - MEDICAL CENTER - RUH MSC Nuclear Med Diagno Imaging / 56-176511 - NUCLEAR MED
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050292P
Medicare Provider Number
050292
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2021
Participating Start Date
4/1/2021
Participating Approval Date
1/22/2021
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
RUHS
Leah Patterson, Chief Nursing Officer
(951) 486-7532
Primary Contact
RUHS
Davalyn Tidwell, Pharmacy Director
(951) 486-4527
Addresses
Street Address
26600 CACTUS AVE STE 100
MORENO VALLEY, CA 92555-3927
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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