340B Drug Pricing Program Database
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DSH510007J ST. MARYS MEDICAL CENTER INC. (Terminated)
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Main Details
Name
ST. MARYS MEDICAL CENTER INC.
Subdivision Name
St. Mary's Infectious Disease
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510007J
Medicare Provider Number
510007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/15/2017
Last Recertification Date
8/23/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
St. Mary's Medical Center
Aaron C Blevins, Chief Pharmacy Officer
(304) 526-8250
Primary Contact
St. Mary's Medical Center
Kathy Walker, 340B Program Coordinator
(304) 526-8748
Addresses
Street Address
2828 First Avenue, Suite 304
Huntington, WV 25702
Billing Address
St Mary's Medical Center
2900 First Avenue
Huntington, WV 25702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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