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DSH510022AX CHARLESTON AREA MEDICAL CENTER (CAMC) (Terminated)
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Main Details
Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
CAMC Memorial Post Cardiac Cath Unit
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510022AX
Medicare Provider Number
510022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2012
Participating Start Date
1/1/2013
Participating Approval Date
11/30/2012
Last Recertification Date
9/3/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Charleston Area Medical Center
STEPHEN BELL, VICE PRESIDENT - FINANCE
(304) 388-6251
Primary Contact
Vandalia Health
Brian Sayre, VP of Pharmacy Services
(304) 388-8917
Addresses
Street Address
3200 MacCorkle Avenue SE
Charleston, WV 25304
Billing Address
CAMC Memorial Hospital Pharmacy
3200 MacCorkle Avenue SE
Charleston, WV 25304
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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