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DSH510053 ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC. (Terminated)
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Main Details
Name
ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH510053
Medicare Provider Number
510053
Additional Details
Current Program Status
Terminated
Registration Date
9/4/2007
Participating Start Date
1/1/2005
Participating Approval Date
9/4/2007
Last Recertification Date
8/19/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Renee A. Hofer, Controller
(304) 473-2185
Primary Contact
St. Josephs Hospital
Eric G. Strother, Director of Pharmacy
(304) 473-2151
Addresses
Street Address
ONE AMALIA DRIVE
BUCKHANNON, WV 26201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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