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SCH510082-00 SUMMERSVILLE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
SUMMERSVILLE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
No
340B ID
SCH510082-00
Medicare Provider Number
510082
Additional Details
Current Program Status
Terminated
Registration Date
4/5/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/17/2017
Last Recertification Date
8/15/2018
Termination Date
Termination Reason
4/1/2019
Other
Contacts
Authorizing Official
WVU Medicine
John Timothy Lewis, CNO, COO
(304) 872-2891
Primary Contact
Summersville Regional Medical Center
Robert Schaub, Director of Pharmacy
(304) 872-8437
Addresses
Street Address
400 FAIRVIEW HEIGHTS ROAD
SUMMERSVILLE, WV 26651
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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