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DSH510001B WEST VIRGINIA UNIVERSITY HOSPITALS, INC. (Terminated)
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Main Details
Name
WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
Subdivision Name
Heart Institute
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510001B
Medicare Provider Number
510001
Outpatient Facility Provider Number
510001
Additional Details
Current Program Status
Terminated
Registration Date
5/11/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/28/2012
Last Recertification Date
8/15/2024
Termination Date
Termination Reason
1/1/2025
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
West Virginia University Healthcare
Justin Gibson, VP of Finance-North Region
(304) 598-4256
Primary Contact
WVU Medicine
Karen Lynn Famoso, Enterprise Director, Compliance and Business Operations
(304) 281-2986
Addresses
Street Address
1 Medical Center Drive
Morgantown, WV 26506
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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