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CAH511316-00 GRANT MEMORIAL HOSPITAL, INC. (Active)
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Main Details
Name
GRANT MEMORIAL HOSPITAL, INC.
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH511316-00
Medicare Provider Number
511316
Additional Details
Current Program Status
Active
Registration Date
8/2/2010
Participating Start Date
8/12/2010
Participating Approval Date
8/4/2010
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Grant Memorial Hospital, Inc.
John B Sylvia, President and CEO
(304) 257-1026 Ext: 5800
Primary Contact
Grant Memorial Hospital, Inc
Brenton R Harman, Director of Pharmacy
(304) 257-1026 Ext: 2440
Addresses
Street Address
117 HOSPITAL DRIVE
PETERSBURG, WV 26847
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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