Covered Entity Details

DSH510031F ST FRANCIS HOSPITAL (Terminated) - information as of 5/20/2025 11:44:33 PM

Main Details

Name

ST FRANCIS HOSPITAL

Subdivision Name

Thomas Health Outpatient Surgery at Saint Francis Hospital

Type

Disproportionate Share Hospital

Rural

340B ID

DSH510031F

Medicare Provider Number

510031

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

1/15/2019

Participating Start Date

4/1/2019

Participating Approval Date

3/7/2019

Last Recertification Date

8/28/2023

Termination Date
Termination Reason

7/1/2024
Other

Contacts

Authorizing Official

Thomas Health System
Jason Gizzi, VP of Finance/CFO
(304) 288-1614

Primary Contact

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

Addresses

Street Address

331 LAIDLEY STREET
SUITE 503
CHARLESTON, WV 25301-1682

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
WV	1040000	1891732889

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH510031A	Child	DSH	ST FRANCIS HOSPITAL	WVU Medicine Thomas Hospitals Podiatry	331 LAIDLEY ST	CHARLESTON	WV	Terminated
DSH510031B	Child	DSH	ST FRANCIS HOSPITAL	Thomas Health Primary and Urgent Care Department of Saint Francis Hospital	333 LAIDLEY ST	CHARLESTON	WV	Terminated
DSH510031C	Child	DSH	ST FRANCIS HOSPITAL	Thomas Health Gastroenterology and General Surgry on Laidley Street Department of Saint Francis Hospital	331 LAIDLEY ST	CHARLESTON	WV	Terminated
DSH510031D	Child	DSH	ST FRANCIS HOSPITAL	Thomas Health Spine and Nerve Center on Court Street Department of Saint Francis Hospital	400 Court Street	Charleston	WV	Terminated
DSH510031E	Child	DSH	ST FRANCIS HOSPITAL	Thomas Health Primary Care on Donnally Street Department of Saint Francis Hospital	500 DONNALLY ST 203	CHARLESTON	WV	Terminated
DSH510031F	Child	DSH	ST FRANCIS HOSPITAL	Thomas Health Outpatient Surgery at Saint Francis Hospital	331 LAIDLEY STREET	CHARLESTON	WV	Terminated
DSH510031G	Child	DSH	ST FRANCIS HOSPITAL	Thomas Health One Day Surgery on Donnally Street at Saint Francis Hospital	500 Donnally Street	Charleston	WV	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	7/1/2024 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		4/30/2024 12:00:00 AM	5/8/2024 8:25 AM
Details	State	Update	Termination Request	Active	To Be Terminated	5/8/2024 8:25 AM
Terminations	Termination Comments	Update	Termination Request		St. Francis Hospital (DSH510031) is under going an internal reorganization and will merge with Thomas Memorial Hospital (DSH510029) effective April 30, 2024 at 11:59PM.	5/8/2024 8:25 AM
Terminations	Termination Date	Update	Termination Request		7/1/2024 12:00:00 AM	5/8/2024 8:25 AM
Terminations	Termination Effective Date	Update	Termination Request		5/1/2024 12:00:00 AM	5/8/2024 8:25 AM
Terminations	Termination Reason	Update	Termination Request		Other	5/8/2024 8:25 AM
Contacts	Primary Contact	Update	Profile Change Request	Nelson, Colin 340B Data Specialist Thomas Health 3047663606	Nelson, Colin Senior Pharmacy Analyst WVU Medicine 3047663606	4/16/2024 7:41 AM
Contacts	Authorizing Official	Update	Change Request	Skeldon, Timothy Chief Financial Officer Thomas Health 3047663428	Gizzi, Jason VP of Finance/CFO Thomas Health System 3042881614	2/29/2024 2:34 PM
Contacts	Primary Contact	Update	Group Change Request	Nelson, Colin 340B Data Specialist Thomas Health System 3047663606	Nelson, Colin 340B Data Specialist Thomas Health 3047663606	10/18/2023 8:27 AM
Contacts	Authorizing Official	Update	Change Request	Skeldon, Timothy Chief Financial Officer Thomas Health 3047663428	Skeldon, Timothy Chief Financial Officer Thomas Health 3047663428	10/17/2023 8:18 AM
Details	Last Recertification Date	Update	Recertification	9/5/2022 4:28:08 PM	8/28/2023 4:21:03 PM	8/28/2023 4:21 PM
Contacts	Primary Contact	Update	PC Change Request	Priddy, Ken 340B Program Director Thomas Memorial Hospital 3047664320	Nelson, Colin 340B Data Specialist Thomas Health System 3047663606	8/14/2023 3:13 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/15/2023 4:48 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1040000	3/15/2023 4:48 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WV	3/15/2023 4:48 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1891732889	3/15/2023 4:48 PM
Medicaid Billing	NPI: State	Insert	Change Request		WV	3/15/2023 4:48 PM
Details	Last Recertification Date	Update	Recertification	8/16/2021 7:47:30 AM	9/5/2022 4:28:08 PM	9/5/2022 4:28 PM
Contacts	Authorizing Official	Update	Change Request	Ulery, Brian Chief Operating Officer Thomas Memorial Hospital 3047663445	Skeldon, Timothy Chief Financial Officer Thomas Health 3047663428	6/6/2022 5:32 PM
Details	Last Recertification Date	Update	Recertification	9/10/2020 10:13:14 AM	8/16/2021 7:47:30 AM	8/16/2021 7:47 AM
Details	Last Recertification Date	Update	Recertification	8/22/2019 9:36:57 AM	9/10/2020 10:13:14 AM	9/10/2020 10:13 AM
Details	Entity Subname	Update	Recertification	SFH GENERAL AND ONCOLOGOCIAL SURGER - Surgery	Thomas Health Outpatient Surgery at Saint Francis Hospital	9/10/2020 10:13 AM
Details	Last Recertification Date	Update	Recertification		8/22/2019 9:36:57 AM	8/22/2019 9:36 AM
Details	State	Update		Approved	Active	4/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Ulery, Brian Chief Operating Officer Thomas Memorial Hospital 3047663445	3/7/2019 9:38 AM
Details	340B ID	Update	New Registration		DSH510031F	3/7/2019 9:38 AM
Details	Entity Subname	Update	New Registration	SFH GENERAL AND ONCOLOGOCIAL SURGER	SFH GENERAL AND ONCOLOGOCIAL SURGER - Surgery	3/7/2019 9:38 AM
Dates	Participating Approval Date	Update	New Registration		3/7/2019 9:38:07 AM	3/7/2019 9:38 AM
Details	State	Update	New Registration	Pending	Approved	3/7/2019 9:38 AM
Dates	Signed By Date	Update	New Registration		1/15/2019 4:54:03 PM	3/7/2019 9:38 AM
Dates	Start Date	Update	New Registration		4/1/2019 12:00:00 AM	3/7/2019 9:38 AM
Addresses	Main Address	Insert	New Registration		331 LAIDLEY STREET SUITE 503 CHARLESTON, WV 25301-1682	1/15/2019 12:04 PM
Contacts	Primary Contact	Insert	New Registration		Priddy, Ken 340B Program Director Thomas Memorial Hospital 3047664320	1/15/2019 12:04 PM
Contacts	Authorizing Official	Insert	New Registration		Ulery, Brian Chief Operating Officer Thomas Memorial Hospital 3047663445	1/15/2019 12:04 PM
Details	Last Recertification Date	Insert	New Registration			1/15/2019 12:04 PM
Details	Grant Number	Insert	New Registration			1/15/2019 12:04 PM
Details	340B ID	Insert	New Registration			1/15/2019 12:04 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/15/2019 12:04 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/15/2019 12:04 PM
Details	Medicare Provider Number	Insert	New Registration		510031	1/15/2019 12:04 PM
Details	Entity Name	Insert	New Registration		ST FRANCIS HOSPITAL	1/15/2019 12:04 PM
Details	Program Code	Insert	New Registration		DSH	1/15/2019 12:04 PM
Details	Entity Subname	Insert	New Registration		SFH GENERAL AND ONCOLOGOCIAL SURGER	1/15/2019 12:04 PM
Dates	Participating Approval Date	Insert	New Registration			1/15/2019 12:04 PM
Details	State	Insert	New Registration		Pending	1/15/2019 12:04 PM
Dates	Registration Date	Insert	New Registration		1/15/2019 12:04:46 PM	1/15/2019 12:04 PM
Dates	Signed By Date	Insert	New Registration			1/15/2019 12:04 PM
Dates	Start Date	Insert	New Registration			1/15/2019 12:04 PM
Terminations	Termination Comments	Insert	New Registration			1/15/2019 12:04 PM
Terminations	Termination Date	Insert	New Registration			1/15/2019 12:04 PM
Terminations	Termination Effective Date	Insert	New Registration			1/15/2019 12:04 PM
Terminations	Termination Reason	Insert	New Registration			1/15/2019 12:04 PM