340B Drug Pricing Program Database
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DSH510029J Thomas Memorial Hospital (Terminated)
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Main Details
Name
Thomas Memorial Hospital
Subdivision Name
Thomas Care Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510029J
Medicare Provider Number
510029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/12/2016
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
4605 MacCorkle Ave SW
South Charleston, WV 25309-1311
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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