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DSH510022DE CHARLESTON AREA MEDICAL CENTER (CAMC) (Active)
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Main Details
Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
CAMC Plastic Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510022DE
Medicare Provider Number
510022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/14/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/26/2017
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
210 Brooks Street
Suite 200
Charleston, WV 25301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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