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DSH390146D WARREN GENERAL HOSPITAL (Terminated)
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Main Details
Name
WARREN GENERAL HOSPITAL
Subdivision Name
Youngsville Walk-In Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390146D
Medicare Provider Number
390146
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/5/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/23/2018
Last Recertification Date
8/21/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Warren General Hospital
Kathryn E. Carlson, Executive Director of Operations
(814) 723-4973 Ext: 1370
Primary Contact
Warren General Hospital
Damion M. Wise, Director of Pharmacy Services
(814) 723-3300 Ext: 1822
Addresses
Street Address
400 E. MAIN STREET
YOUNGSVILLE, PA 16371
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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