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CAH361319-00 SELBY GENERAL HOSPITAL (Active)
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Main Details
Name
SELBY GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH361319-00
Medicare Provider Number
361319
Additional Details
Current Program Status
Active
Registration Date
4/22/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/15/2011
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Selby General Hospital
Jody Lynn Bullman, President
(740) 568-2090
Primary Contact
Marietta Memorial Hospital Memorial Health System
Matthew Budzyn, Pharmacy Director
(740) 374-1720
Addresses
Street Address
1106 COLEGATE DRIVE
MARIETTA, OH 45750
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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