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HOMECHOICE PARTNERS LLC
DSH490037 RIVERSIDE SHORE MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
RIVERSIDE SHORE MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH490037
Entity Address
20480 Market Street
Onancock, VA 23417
Medicare Provider Number
490037
Participating Start Date
7/1/2004
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
HOMECHOICE PARTNERS LLC
Pharmacy Address
DBA BIOSCRIP INFUSION SERVICES
5365 ROBIN HOOD RD STE 200
NORFOLK, VA 23513
Pharmacy Comments
Contract Details
Approval Date
10/18/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Contract Pharmacy Representative
Bioscrip
Keyur Mehta, VP Strategic Operations
(703) 401-4717
Signed By Date
10/18/2016
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