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RRC040004-00 WASHINGTON REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
WASHINGTON REGIONAL MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC040004-00
Medicare Provider Number
040004
Additional Details
Current Program Status
Active
Registration Date
1/4/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/12/2022
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Washington Regional Medical Center
Dennis Charles Burrows, Vice President & Chief Accounting Officer
(479) 463-1120
Primary Contact
Washington Regional Medical System
Daniel Bishop, Director of Pharmacy
(479) 463-1122
Addresses
Street Address
3215 N. NORTH HILLS BLVD
FAYETTEVILLE, AR 72703
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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