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CAH511313-01 BOONE MEMORIAL HOSPITAL (Active)
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Main Details
Name
BOONE MEMORIAL HOSPITAL
Subdivision Name
BOONE MEMORIAL HOSPITAL MEDICAL CLINIC
Type
Critical Access Hospital
Rural
No
340B ID
CAH511313-01
Medicare Provider Number
511313
Outpatient Facility Provider Number
513411
Additional Details
Current Program Status
Active
Registration Date
12/1/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/2/2010
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Boone Memorial Hospital Inc.
Virgil Lee Underwood, CEO
(304) 369-1230 Ext: 5507
Primary Contact
Boone Memorial Hospital
Angela Christian, Executive Director of Ancillary Services
(304) 369-1230 Ext: 5517
Addresses
Street Address
660 South Main Street Suite A
MADISON, WV 25130
Billing Address
Boone Memorial Hospital, Inc.
701 Madison Avenue
Madison, WV 25130
Comments
Medicaid Billing
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