340B Drug Pricing Program Database
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DSH510029A Thomas Memorial Hospital (Terminated)
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Main Details
Name
Thomas Memorial Hospital
Subdivision Name
Thomas Health Outpatient Center on Kanawha Avenue Department of Thomas Memorial Hospital
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510029A
Medicare Provider Number
510029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/7/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/10/2014
Last Recertification Date
8/28/2023
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Thomas Health System
Jason Gizzi, VP of Finance/CFO
(304) 288-1614
Primary Contact
WVU Medicine
Colin Nelson, Senior Pharmacy Analyst
(304) 766-3606
Addresses
Street Address
4610 Kanawha Avenue SW
South Charleston, WV 25309
Billing Address
Thomas Memorial Hospital
4605 MacCorkle Avenue, SW
South Charleston, WV 25309
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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