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DSH510022AV CHARLESTON AREA MEDICAL CENTER (CAMC) (Active)
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Main Details
Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
OP Imaging Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510022AV
Medicare Provider Number
510022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/10/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/17/2012
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
CAMC Health System
Jeff D Sandene, EVP CFO
(304) 388-7603
Primary Contact
Vandalia Health
Brian Sayre, VP of Pharmacy Services
(304) 388-8917
Addresses
Street Address
3416 MacCorkle Ave. SE
Charleston, WV 25304
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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