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CAH361302-00 TRINITY HOSPITAL TWIN CITY (Active)
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Main Details
Name
TRINITY HOSPITAL TWIN CITY
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361302-00
Medicare Provider Number
361302
Additional Details
Current Program Status
Active
Registration Date
4/1/2013
Participating Start Date
7/1/2013
Participating Approval Date
4/26/2013
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Trinity Health System
Dave Werkin, CFO
(740) 264-8695
Primary Contact
Trinity Hospital Twin CIty
Eric Durbin, Director of Pharmacy
(740) 922-7467
Addresses
Street Address
819 N 1st STREET
DENNISON, OH 44621-1003
Billing Address
TRINITY HOSPITAL TWIN CITY
PO BOX 2400
Phoenix, AZ 85002-6000
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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