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RRC510039-00 Ohio Valley Medical Center, Incorporated (Terminated)
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Main Details
Name
Ohio Valley Medical Center, Incorporated
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC510039-00
Medicare Provider Number
510039
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/9/2013
Last Recertification Date
8/13/2015
Termination Date
Termination Reason
4/1/2016
Change of covered entity type
Contacts
Authorizing Official
Lisa M. Simon, Senior Vice President & CFO
(304) 234-8407
Primary Contact
Karen Famoso, Director of Pharmacy
(304) 234-1816
Addresses
Street Address
2000 Eoff Street
Wheeling, WV 26003
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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