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DSH390146B WARREN GENERAL HOSPITAL (Terminated)
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Main Details
Name
WARREN GENERAL HOSPITAL
Subdivision Name
St. Clair General Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390146B
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
8/18/2021
Termination Date
Termination Reason
10/1/2022
Other
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
103 ST CLAIR ST
2E
WARREN, PA 16365
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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