340B Drug Pricing Program Database
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DSH510055H Cabell Huntington Hospital, Inc. (Terminated)
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Main Details
Name
Cabell Huntington Hospital, Inc.
Subdivision Name
Cabell Huntington Hospital Pediatrics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510055H
Medicare Provider Number
510055
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
5/7/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/21/2012
Last Recertification Date
8/25/2022
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
St. Mary's Medical Center
Aaron C Blevins, Chief Pharmacy Officer
(304) 526-8250
Primary Contact
Cabell Huntington Hospital
Rebecca Briana Crutchley, 340B Coordinator
(304) 399-4690
Addresses
Street Address
1115 20th Street
Suite 105
Huntington, WV 25703
Billing Address
Cabell Huntington Hospital, Inc.
1340 Hal Greer Blvd.
Huntington, WV 25701-0195
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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5/10/12 Requested supporting docs
05/10/2012
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