340B Drug Pricing Program Database


DSH510029Y Thomas Memorial Hospital (Active) - information as of 5/13/2025 10:47:14 PM

Main Details
Thomas Memorial Hospital
Thomas Health Urgent Care in Nitro Department of Thomas Memorial Hospital
Disproportionate Share Hospital
No
DSH510029Y
510029


Additional Details
Active
1/10/2017
4/1/2017
2/21/2017
8/16/2024

Contacts

WVU Medicine Thomas Hospitals
Rachel Stephanie Jones, CFO
(304) 766-3428

WVU Medicine
Colin Nelson, Senior Pharmacy Analyst
(304) 766-3606

Addresses

6 BANK STREET
NITRO, WV 25143-1708

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
OH 1316925506,1275620809
PA 1316925506,1275620809
VA 1316925506,1275620809
KY 1316925506,1275620809
WV 1275620809,1316925506
Shipping Addresses

THOMAS MEMORIAL HOSPITAL
4605 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25309

West Virginia United Health System Inc DBA Enterprise Pharmacy Solutions
781 Chestnut Ridge Rd.
Suite 600
Morgantown, WV 26505-0015
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH510029AChildDSHThomas Memorial HospitalThomas Health Outpatient Center on Kanawha Avenue Department of Thomas Memorial Hospital4610 Kanawha Avenue SWSouth CharlestonWVTerminated
DSH510029AAChildDSHThomas Memorial HospitalThomas Health Neurology on Division Street Department of Thomas Memorial Hospital424 Division StreetSouth CharlestonWVTerminated
DSH510029ABChildDSHThomas Memorial HospitalThomas Health General Surgery on Division Street Department of Thomas Memorial Hospital434 Division StreetSouth CharlestonWVActive
DSH510029ACChildDSHThomas Memorial HospitalWVU Medicine Thomas Hospitals Infectious Disease4607 MacCorkle Ave SW.South CharlestonWVActive
DSH510029ADChildDSHThomas Memorial HospitalThomas Health Primary Care on Kentucky Street Department of Thomas Memorial Hospital4820 Kentucky StreetSouth CharlestonWVActive
DSH510029AEChildDSHThomas Memorial HospitalThomas Health Uro-Gynecology at Thomas Memeorial Hospital - Gynecology, Urology4607 MacCorkle Ave SWSouth CharlestonWVActive
DSH510029AFChildDSHThomas Memorial HospitalWVU Medicine Thomas Hospitals Pulmonology - Pulmonology4619 Kanawha Ave SW.South CharlestonWVActive
DSH510029AGChildDSHThomas Memorial HospitalWVU Medicine Thomas Hospitals Nephrology - Nephrology401 Division St.South CharlestonWVActive
DSH510029AJChildDSHThomas Memorial HospitalWVU Medicine Thomas Hospitals Primary Care Donnally St. - Primary Care500 Donnally StCharlestonWVActive
DSH510029AKChildDSHThomas Memorial HospitalSFH Outpatient Surgery - Outpatient Surgery331 Laidley St.CharlestonWVActive
DSH510029AMChildDSHThomas Memorial HospitalSpine and Nerve on Court St. - Spine and Nerve400 Court St.CharlestonWVActive
DSH510029ANChildDSHThomas Memorial HospitalOne Day Surgery on Donnally St. - One Day Surgery500 Donnally St.CharlestonWVActive
DSH510029APChildDSHThomas Memorial HospitalSFH Physical Therapy - Physical Therapy333 Laidley St.CharlestonWVActive
DSH510029AQChildDSHThomas Memorial HospitalSFH Hyperbaric - Hyperbaric333 Laidley St.CharlestonWVActive
DSH510029ARChildDSHThomas Memorial HospitalSFH Laboratory - Laboratory333 Laidley St.CharlestonWVActive
DSH510029ASChildDSHThomas Memorial HospitalSFH Cardiac Catheterization - Cardiac Catheterization333 Laidley St.CharlestonWVActive
DSH510029ATChildDSHThomas Memorial HospitalSFH CT Scan - CT333 Laidley StCharlestonWVActive
DSH510029AUChildDSHThomas Memorial HospitalSFH Operating Room - Operating Room333 Laidley St.CharlestonWVActive
DSH510029AVChildDSHThomas Memorial HospitalSFH Radiology-Diagnostic - Radiology333 Laidley StCharlestonWVActive
DSH510029AWChildDSHThomas Memorial HospitalSFH Respiratory Therapy - Respiratory Therapy333 Laidley St.CharlestonWVActive
DSH510029AXChildDSHThomas Memorial HospitalSFH Observation 1 West - Observation333 Laidley St.CharlestonWVActive
DSH510029AYChildDSHThomas Memorial HospitalThomas Outpatient Diagnostic Center in Spring Hill - Diagnostic Radiology4800 Kanawha Ave SWSouth CharlestonWVActive
DSH510029AZChildDSHThomas Memorial HospitalAmbulatory Infusion - Infusion Services424 Division St.South CharlestonWVTerminated
DSH510029BChildDSHThomas Memorial HospitalThomas Metro MRIAshton Place Shopping CenterCharlestonWVActive
DSH510029CChildDSHThomas Memorial HospitalThomas Health Outpatient Surgery at Thomas Memorial Hospital4605 MacCorkle Ave, SWSouth CharlestonWVTerminated
DSH510029DChildDSHThomas Memorial HospitalThomas Health Behavorial Health Outpatient at Saint Francis Hospital Department of Thomas Memorial Hospital331 Laidley StreetCharlestonWVTerminated
DSH510029EChildDSHThomas Memorial HospitalThomas Sleep Center4619 Kanawha Ave SWSouth CharlestonWVActive
DSH510029FChildDSHThomas Memorial HospitalThomas Health Outpatient Center on Teays Valley Road Department of Thomas Memorial Hospital4004 State Route 34HurricaneWVTerminated
DSH510029GChildDSHThomas Memorial HospitalHome Health Services4825 MacCorkle Avenue, SWSouth CharlestonWVTerminated
DSH510029HChildDSHTHOMAS MEMORIAL HOSPITALThomas Care Clinic-WVSU301 Washington Ave Suite 004DunbarWVTerminated
DSH510029JChildDSHThomas Memorial HospitalThomas Care Clinic4605 MacCorkle Ave SWSouth CharlestonWVTerminated
DSH510029KChildDSHThomas Memorial HospitalThomas Health Endocrinology on Poplar Street Department of Thomas Memorial Hospital500 Poplar StSouth CharlestonWVActive
DSH510029LChildDSHThomas Memorial HospitalTMH Family Practice Associates500 Poplar St Suite 304South CharlestonWVTerminated
DSH510029MChildDSHThomas Memorial HospitalThomas Health Endocrinology on Division Street Department of Thomas Memorial Hospital436 Division StSouth CharlestonWVActive
DSH510029NChildDSHThomas Memorial HospitalThomas Health Urology on Kanawha Avenue Department of Thomas Memorial Hospital4610 Kanawha Ave SW Suite 401South CharlestonWVActive
DSH510029PChildDSHThomas Memorial HospitalThomas Health Hematology Oncology at Thomas Memorial Hospital500 Poplar St.South CharlestonWVActive
DSH510029QChildDSHThomas Memorial HospitalTMH Pulmonology401 Division St Suite 106South CharlestonWVTerminated
DSH510029RChildDSHThomas Memorial HospitalThomas Health Primary Care at Thomas Memorial Hospital401 Division St Suite 205South CharlestonWVTerminated
DSH510029SChildDSHThomas Memorial HospitalThomas Health General Surgery on Poplar Street Department of Thomas Memorial Hospital500 POPLAR ST SUITE 304SOUTH CHARLESTONWVActive
DSH510029TChildDSHThomas Memorial HospitalTMH UROLOGY432 DIVISION STSOUTH CHARLESTONWVTerminated
DSH510029UChildDSHThomas Memorial HospitalThomas Health Primary Care in Winfield Department of Thomas Memorial Hospital11924 WINFIELD ROADWINFIELDWVActive
DSH510029VChildDSHThomas Memorial HospitalThomas Health Primary Care on Division Street Department of Thomas Memorial Hospital400 DIVISION STREETSOUTH CHARLESTONWVActive
DSH510029WChildDSHThomas Memorial HospitalThomas Health Primary Care on Chestnut Street Department of Thomas Memorial Hospital506 CHESTNUT STREETSOUTH CHARLESTONWVActive
DSH510029XChildDSHThomas Memorial HospitalThomas Health Primary Care And Endocrinology at Ashton Department of Thomas Memorial Hospital1097 FLEDDERJOHN ROADCHARLESTONWVActive
DSH510029YChildDSHThomas Memorial HospitalThomas Health Urgent Care in Nitro Department of Thomas Memorial Hospital6 BANK STREETNITROWVActive
DSH510029ZChildDSHThomas Memorial HospitalWVU Medicine Thomas Hospitals Psychiatry333 Laidley St 4 EastCharlestonWVActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressInsertGroup Change Request West Virginia United Health System Inc DBA Enterprise Pharmacy Solutions 781 Chestnut Ridge Rd. Suite 600 Morgantown, WV 26505-001510/17/2024 8:06 AM
DetailsLast Recertification DateUpdateRecertification8/28/2023 4:18:50 PM8/16/2024 8:41:18 AM8/16/2024 8:41 AM
ContactsAuthorizing OfficialUpdateChange RequestGizzi, Jason VP of Finance/CFO Thomas Health System 3042881614Jones, Rachel Stephanie CFO WVU Medicine Thomas Hospitals 30476634287/23/2024 8:22 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 13169255066/12/2024 11:11 AM
Medicaid BillingNPI: StateInsertGroup Change Request WV6/12/2024 11:11 AM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request1391000 (WV) 6/11/2024 10:07 AM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request3810024049 (WV) 6/11/2024 10:07 AM
Medicaid BillingNPI: NumberDeleteGroup Change Request1871866806 (WV) 6/11/2024 10:07 AM
Medicaid BillingNPI: NumberDeleteGroup Change Request1316925506 (WV) 6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 13169255066/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request OH6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 12756208096/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request OH6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 13169255066/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request PA6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 12756208096/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request PA6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 13169255066/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request VA6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 12756208096/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request VA6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 13169255066/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request KY6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 12756208096/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request KY6/11/2024 10:07 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 12756208096/11/2024 10:07 AM
Medicaid BillingNPI: StateInsertGroup Change Request WV6/11/2024 10:07 AM
ContactsPrimary ContactUpdateProfile Change RequestNelson, Colin 340B Data Specialist Thomas Health 3047663606Nelson, Colin Senior Pharmacy Analyst WVU Medicine 30476636064/16/2024 7:41 AM
Medicaid BillingNPI: NumberInsertChange Request 13169255064/10/2024 12:26 PM
Medicaid BillingNPI: StateInsertChange Request WV4/10/2024 12:26 PM
ContactsAuthorizing OfficialUpdateChange RequestSkeldon, Timothy Chief Financial Officer Thomas Health 3047663428Gizzi, Jason VP of Finance/CFO Thomas Health System 30428816143/4/2024 7:00 AM
ContactsPrimary ContactUpdateGroup Change RequestNelson, Colin 340B Data Specialist Thomas Health System 3047663606Nelson, Colin 340B Data Specialist Thomas Health 304766360610/12/2023 4:13 PM
ContactsAuthorizing OfficialUpdateChange RequestSkeldon, Timothy Chief Financial Officer Thomas Health 3047663428Skeldon, Timothy Chief Financial Officer Thomas Health 304766342810/11/2023 8:28 AM
DetailsLast Recertification DateUpdateRecertification9/5/2022 4:33:39 PM8/28/2023 4:18:50 PM8/28/2023 4:18 PM
ContactsPrimary ContactUpdatePC Change RequestPriddy, Ken 340B Program Director Thomas Memorial Hospital 3047664320Nelson, Colin 340B Data Specialist Thomas Health System 30476636068/14/2023 12:25 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/15/2023 4:54 PM
Medicaid BillingMedicaid: NumberInsertChange Request 13910003/15/2023 4:54 PM
Medicaid BillingMedicaid: StateInsertChange Request WV3/15/2023 4:54 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/15/2023 4:54 PM
Medicaid BillingMedicaid: NumberInsertChange Request 38100240493/15/2023 4:54 PM
Medicaid BillingMedicaid: StateInsertChange Request WV3/15/2023 4:54 PM
Medicaid BillingNPI: NumberInsertChange Request 18718668063/15/2023 4:54 PM
Medicaid BillingNPI: StateInsertChange Request WV3/15/2023 4:54 PM
DetailsLast Recertification DateUpdateRecertification8/16/2021 7:55:10 AM9/5/2022 4:33:39 PM9/5/2022 4:33 PM
ContactsAuthorizing OfficialUpdateChange RequestUlery, Brian Chief Operating Officer Thomas Memorial Hospital 3047663445Skeldon, Timothy Chief Financial Officer Thomas Health 30476634286/9/2022 8:25 AM
DetailsLast Recertification DateUpdateRecertification9/8/2020 1:14:25 PM8/16/2021 7:55:10 AM8/16/2021 7:55 AM
DetailsLast Recertification DateUpdateRecertification8/27/2019 7:41:11 PM9/8/2020 1:14:25 PM9/8/2020 1:14 PM
DetailsEntity SubnameUpdateRecertificationTHOMAS CARE CLINIC-NITROThomas Health Urgent Care in Nitro Department of Thomas Memorial Hospital9/8/2020 1:14 PM
ContactsAuthorizing OfficialUpdateChange RequestUlery, Brian L Chief Operating Officer (COO) Thomas Health 3047663445Ulery, Brian Chief Operating Officer Thomas Memorial Hospital 30476634454/23/2020 2:29 PM
DetailsLast Recertification DateUpdateRecertification8/20/2018 8:21:36 AM8/27/2019 7:41:11 PM8/27/2019 7:41 PM
DetailsLast Recertification DateUpdateRecertification12/4/2017 4:19:01 PM8/20/2018 8:21:36 AM8/20/2018 8:21 AM
DetailsEntity NameUpdateRecertificationTHOMAS MEMORIAL HOSPITALThomas Memorial Hospital12/4/2017 4:48 PM
DetailsLast Recertification DateUpdateRecertification 12/4/2017 4:19:01 PM12/4/2017 4:19 PM
ContactsAuthorizing OfficialUpdate Ulery, Brian Chief Operating Officer (COO) 3047663445Ulery, Brian L Chief Operating Officer (COO) Thomas Health 304766344512/4/2017 3:59 PM
ContactsSigned ByUpdate Ulery, Brian Chief Operating Officer (COO) 3047663445Ulery, Brian L Chief Operating Officer (COO) Thomas Health 304766344512/4/2017 3:59 PM
ContactsPrimary ContactUpdate Priddy, Ken 340B Program Director 3047664320Priddy, Ken 340B Program Director Thomas Memorial Hospital 30476643209/26/2017 1:37 PM
ContactsAuthorizing OfficialInsert  Ulery, Brian Chief Operating Officer (COO) 30476634458/2/2017 3:08 PM
ContactsSigned ByInsert  Ulery, Brian Chief Operating Officer (COO) 30476634458/2/2017 3:08 PM
ContactsPrimary ContactInsert  Priddy, Ken 340B Program Director 30476643206/21/2017 9:21 AM
AddressesMain AddressInsert   6 BANK STREET NITRO, WV 25143-17082/21/2017 5:16 PM
AddressesShipping AddressInsert  THOMAS MEMORIAL HOSPITAL 4605 MACCORKLE AVE SW SOUTH CHARLESTON, WV 253092/21/2017 5:16 PM
DatesParticipating Approval DateUpdate  2/21/2017 12:00:00 AM2/21/2017 5:16 PM
DetailsStateUpdate PendingActive2/21/2017 5:16 PM
DatesStart DateUpdate  4/1/2017 12:00:00 AM2/21/2017 5:16 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REG_74280DSH510029Y2/7/2017 10:06 AM
Details340B IDUpdate  OUTPATIENT_ONLINE_REG_742801/10/2017 9:16 AM
DetailsLast Recertification DateInsert   1/10/2017 9:16 AM
DetailsGrant NumberInsert   1/10/2017 9:16 AM
Details340B IDInsert   1/10/2017 9:16 AM
DetailsIs Authorizing Official EHB DataInsert   1/10/2017 9:16 AM
DatesLast Date That 340B Drugs PurchasedInsert   1/10/2017 9:16 AM
DetailsMedicare Provider NumberInsert  5100291/10/2017 9:16 AM
DetailsEntity NameInsert  THOMAS MEMORIAL HOSPITAL1/10/2017 9:16 AM
DetailsProgram CodeInsert  DSH1/10/2017 9:16 AM
DetailsEntity SubnameInsert  THOMAS CARE CLINIC-NITRO1/10/2017 9:16 AM
DatesParticipating Approval DateInsert   1/10/2017 9:16 AM
DetailsStateInsert  Pending1/10/2017 9:16 AM
DatesRegistration DateInsert  1/10/2017 12:00:00 AM1/10/2017 9:16 AM
DatesSigned By DateInsert  1/10/2017 12:00:00 AM1/10/2017 9:16 AM
DatesStart DateInsert   1/10/2017 9:16 AM
TerminationsTermination CommentsInsert   1/10/2017 9:16 AM
TerminationsTermination DateInsert   1/10/2017 9:16 AM
TerminationsTermination Effective DateInsert   1/10/2017 9:16 AM
TerminationsTermination ReasonInsert   1/10/2017 9:16 AM