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DSH510022CT CHARLESTON AREA MEDICAL CENTER (CAMC) (Terminated)
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Main Details
Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
CAMC Gastroenterology (GI) Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510022CT
Medicare Provider Number
510022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/17/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/14/2016
Last Recertification Date
9/10/2020
Termination Date
Termination Reason
4/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Charleston Area Medical Center
STEPHEN BELL, VICE PRESIDENT - FINANCE
(304) 388-6251
Primary Contact
Vandalia Health
Brian Sayre, VP of Pharmacy Services
(304) 388-8917
Addresses
Street Address
3200 MacCorkle Avenue, S.E.
Charleston, WV 25304
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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