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CAH511320-00 Community Health Association (Active)
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Main Details
Name
Community Health Association
Subdivision Name
Jackson General Hospital
Type
Critical Access Hospital
Rural
No
340B ID
CAH511320-00
Medicare Provider Number
511320
Additional Details
Current Program Status
Active
Registration Date
1/2/2013
Participating Start Date
4/1/2013
Participating Approval Date
1/8/2013
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Jackson General Hospital
William Russell Smith, Director of Finance
(304) 917-2682
Primary Contact
Jackson General Hospital
Dennis Chad Foreman, Director of Pharmacy
(304) 373-1604
Addresses
Street Address
122 Pinnell Street
Ripley, WV 25271-9101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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