340B Drug Pricing Program Database
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CAH511315-00 POTOMAC VALLEY HOSPITAL (Active)
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Main Details
Name
POTOMAC VALLEY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH511315-00
Medicare Provider Number
511315
Additional Details
Current Program Status
Active
Registration Date
1/11/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/16/2016
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
West Virginia University Healthcare
Justin Gibson, VP of Finance-North Region
(304) 598-4256
Primary Contact
WVU Medicine
Jessica Ileen Calderone, Enterprise 340B Program Manager
(304) 598-4000 Ext: 70847
Addresses
Street Address
100 PIN OAK LANE
KEYSER, WV 26726
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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