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DSH510001AT WEST VIRGINIA UNIVERSITY HOSPITALS, INC. (Active)
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Main Details
Name
WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
Subdivision Name
Emergency - ED - FMT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510001AT
Medicare Provider Number
510001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/3/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/10/2024
Last Recertification Date
Contacts
Authorizing Official
West Virginia University Healthcare
Justin Gibson, VP of Finance-North Region
(304) 598-4256
Primary Contact
WVU Medicine
Karen Lynn Famoso, Enterprise Director, Compliance and Business Operations
(304) 281-2986
Addresses
Street Address
1325 Locust Avenue
Fairmont, WV 26554
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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