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RRC360147-18 MARIETTA MEMORIAL HOSPITAL (Active)
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Main Details
Name
MARIETTA MEMORIAL HOSPITAL
Subdivision Name
Endocrinology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360147-18
Medicare Provider Number
360147
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/19/2020
Participating Start Date
5/20/2020
Participating Approval Date
5/20/2020
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Marietta Memorial Hospital
Doug Full, Director of Finance
(740) 374-1698
Primary Contact
Marietta Memorial Hospital
David Layne, 340B Pharmacy Analyst
(606) 922-3796
Addresses
Street Address
803 Farson Street
Suite 100
Belpre, OH 45714
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2015, terminated 4/1/2020. Reinstated 7/1/2020.
05/20/2020
May 2025
May 2025
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