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DSH510022BY CHARLESTON AREA MEDICAL CENTER (CAMC) (Active)
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Main Details
Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
CAMC Pediatric Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510022BY
Medicare Provider Number
510022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/21/2016
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
CAMC Health System
Jeff D Sandene, EVP CFO
(304) 388-7603
Primary Contact
Vandalia Health
Brian Sayre, VP of Pharmacy Services
(304) 388-8917
Addresses
Street Address
830 Pennsylvania Avenue
Suite 202
Charleston, WV 25302
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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