Covered Entity Details

CAH361321-02 BARNESVILLE HOSPITAL ASSOCIATION INC. (Active) - information as of 5/10/2025 11:07:49 PM

Main Details

Name

BARNESVILLE HOSPITAL ASSOCIATION INC.

Subdivision Name

Morristown Family Medicine - Rural Health Center - Family Medicine

Type

Critical Access Hospital

Rural

340B ID

CAH361321-02

Medicare Provider Number

361321

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/7/2023

Participating Start Date

10/1/2023

Participating Approval Date

7/20/2023

Last Recertification Date

8/12/2024

Contacts

Authorizing Official

WVU Medicine Barnesville / Harrison
Judy D Bruno, President & CEO
(740) 425-3941

Primary Contact

Barnesville Hospital
Amy Perry, Lead Pharmacist
(740) 425-5108

Addresses

Street Address

66840 Belmont-Morristown Rd
Belmont, OH 43718

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		1235135450,1538747845,1134827546,1053999367
PA		1235135450,1538747845,1134827546,1053999367
VA		1235135450,1538747845,1134827546,1053999367
KY		1235135450,1538747845,1134827546,1053999367
OH		1538747845,1134827546,1053999367,1235135450

Shipping Addresses

Shipping Address 1

West Virginia United Health System Inc DBA Enterprise Pharmacy Solutions
781 Chestnut Ridge Rd
Suite 600
Morgantown, WV 26505-0015

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
CAH361321-01	Child	CAH	BARNESVILLE HOSPITAL ASSOCIATION INC.	Barnesville Family Medicine - Rural Health Center - Family Medicine	100 Hospital Drive	Barnesville	OH	Active
CAH361321-02	Child	CAH	BARNESVILLE HOSPITAL ASSOCIATION INC.	Morristown Family Medicine - Rural Health Center - Family Medicine	66840 Belmont-Morristown Rd	Belmont	OH	Active
CAH361321-03	Child	CAH	BARNESVILLE HOSPITAL ASSOCIATION INC.	Barnesville Family Medicine East - Family Medicine Rural Health Clinic	1119 East Main Street	Barnesville	OH	Active
CAH361321-04	Child	CAH	BARNESVILLE HOSPITAL ASSOCIATION INC.	General Surgery - General Surgery	100 Hospital Drive	Barnesville	OH	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Change Request	Armstrong, Stacey Kay President & CEO WVU Medicine Barnesville Harrison 7404253941	Bruno, Judy D President & CEO WVU Medicine Barnesville / Harrison 7404253941	2/25/2025 9:59 AM
Addresses	Shipping Address	Insert	Group Change Request		West Virginia United Health System Inc DBA Enterprise Pharmacy Solutions 781 Chestnut Ridge Rd Suite 600 Morgantown, WV 26505-0015	10/23/2024 9:33 AM
Contacts	Primary Contact	Update	Profile Change Request	Perry, Amy Pharmacy Director Barnesville Hospital 7404255108	Perry, Amy Lead Pharmacist Barnesville Hospital 7404255108	10/22/2024 8:05 AM
Details	Last Recertification Date	Update	Recertification		8/12/2024 2:54:14 PM	8/12/2024 2:54 PM
Contacts	Authorizing Official	Update	AO Change Request	Phillips, David President and CEO WVU Medicine Ohio Hospitals 7404255101	Armstrong, Stacey Kay President & CEO WVU Medicine Barnesville Harrison 7404253941	7/10/2024 7:29 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1235135450	6/11/2024 11:44 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		OH	6/11/2024 11:44 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1235135450	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		WV	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1235135450	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		PA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1235135450	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		VA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1235135450	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		KY	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1538747845	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		WV	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1538747845	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		OH	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1538747845	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		PA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1538747845	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		VA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1538747845	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		KY	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1134827546	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		WV	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1134827546	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		OH	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1134827546	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		PA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1134827546	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		VA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1134827546	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		KY	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1053999367	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		WV	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1053999367	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		OH	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1053999367	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		PA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1053999367	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		VA	6/4/2024 7:59 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1053999367	6/4/2024 7:59 AM
Medicaid Billing	NPI: State	Insert	Group Change Request		KY	6/4/2024 7:59 AM
Details	State	Update		Approved	Active	10/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Phillips, David President and CEO WVU Medicine Ohio Hospitals 7404255101	7/20/2023 12:45 PM
Details	340B ID	Update	New Registration		CAH361321-02	7/20/2023 12:45 PM
Details	Entity Name	Update	New Registration	BARNESVILLE HOSPITAL	BARNESVILLE HOSPITAL ASSOCIATION INC.	7/20/2023 12:45 PM
Details	Entity Subname	Update	New Registration	Morristown Family Medicine - Rural Health Center	Morristown Family Medicine - Rural Health Center - Family Medicine	7/20/2023 12:45 PM
Dates	Participating Approval Date	Update	New Registration		7/20/2023 12:45:56 PM	7/20/2023 12:45 PM
Details	State	Update	New Registration	Pending	Approved	7/20/2023 12:45 PM
Dates	Signed By Date	Update	New Registration		7/10/2023 8:34:39 AM	7/20/2023 12:45 PM
Dates	Start Date	Update	New Registration		10/1/2023 12:00:00 AM	7/20/2023 12:45 PM
Addresses	Main Address	Insert	New Registration		66840 Belmont-Morristown Rd Belmont, OH 43718	7/7/2023 11:58 AM
Contacts	Authorizing Official	Insert	New Registration		Phillips, David President and CEO WVU Medicine Ohio Hospitals 7404255101	7/7/2023 11:58 AM
Contacts	Primary Contact	Insert	New Registration		Perry, Amy Pharmacy Director Barnesville Hospital 7404255108	7/7/2023 11:58 AM
Details	Assistance Received From Date	Insert	New Registration			7/7/2023 11:58 AM
Details	Assistance Received To Date	Insert	New Registration			7/7/2023 11:58 AM
Details	Last Recertification Date	Insert	New Registration			7/7/2023 11:58 AM
Details	Grant Number	Insert	New Registration			7/7/2023 11:58 AM
Details	340B ID	Insert	New Registration			7/7/2023 11:58 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/7/2023 11:58 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/7/2023 11:58 AM
Details	Medicare Provider Number	Insert	New Registration		361321	7/7/2023 11:58 AM
Details	Entity Name	Insert	New Registration		BARNESVILLE HOSPITAL	7/7/2023 11:58 AM
Details	NOFO Number	Insert	New Registration			7/7/2023 11:58 AM
Details	Program Code	Insert	New Registration		CAH	7/7/2023 11:58 AM
Details	Entity Subname	Insert	New Registration		Morristown Family Medicine - Rural Health Center	7/7/2023 11:58 AM
Dates	Participating Approval Date	Insert	New Registration			7/7/2023 11:58 AM
Details	State	Insert	New Registration		Pending	7/7/2023 11:58 AM
Dates	Registration Date	Insert	New Registration		7/7/2023 11:58:19 AM	7/7/2023 11:58 AM
Dates	Signed By Date	Insert	New Registration			7/7/2023 11:58 AM
Dates	Start Date	Insert	New Registration			7/7/2023 11:58 AM
Terminations	Termination Comments	Insert	New Registration			7/7/2023 11:58 AM
Terminations	Termination Date	Insert	New Registration			7/7/2023 11:58 AM
Terminations	Termination Effective Date	Insert	New Registration			7/7/2023 11:58 AM
Terminations	Termination Reason	Insert	New Registration			7/7/2023 11:58 AM