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DSH510046E PRINCETON COMMUNITY HOSPITAL (Active)
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Main Details
Name
PRINCETON COMMUNITY HOSPITAL
Subdivision Name
PRINCETON COMMUNITY HOSPITAL ASSOC. - Bluefield Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH510046E
Medicare Provider Number
510046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2024
Participating Start Date
1/1/2025
Participating Approval Date
11/4/2024
Last Recertification Date
Contacts
Authorizing Official
Princeton Community Hospital Association, Inc.
Diane Lynn Spencer, VP of Finance/CFO
(304) 487-7505
Primary Contact
Princeton Community Hospital
Daniel Paul Morrison, Director of Pharmacy
(304) 487-7564
Addresses
Street Address
510 CHERRY ST
STE 206
BLUEFIELD, WV 24701-3300
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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