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DSH510012 PLEASANT VALLEY HOSPITAL (Terminated)
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Main Details
Name
PLEASANT VALLEY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH510012
Medicare Provider Number
510012
Additional Details
Current Program Status
Terminated
Registration Date
5/31/2006
Participating Start Date
7/1/2006
Participating Approval Date
6/1/2006
Last Recertification Date
8/14/2024
Termination Date
Termination Reason
4/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
St. Mary's Medical Center
Aaron C Blevins, Chief Pharmacy Officer
(304) 526-8250
Primary Contact
Pleasant Valley Hospital
John Beaver, Pharmacy Director
(304) 675-4340 Ext: 1160
Addresses
Street Address
2520 VALLEY DRIVE
POINT PLEASANT, WV 25550
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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