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RRC360211-03 TRINITY HOSPITAL HOLDING COMPANY (Terminated)
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Main Details
Name
TRINITY HOSPITAL HOLDING COMPANY
Subdivision Name
Trinity Encoscopy Center - Endoscopy Services
Type
Rural Referral Center
Rural
No
340B ID
RRC360211-03
Medicare Provider Number
360211
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/23/2019
Last Recertification Date
8/23/2021
Termination Date
Termination Reason
4/1/2022
Change of covered entity type
Contacts
Authorizing Official
Trinity Health System
Dave Werkin, CFO
(740) 264-8695
Primary Contact
Trinity Health System
Jennifer Davis, System Director of Pharmacy
(740) 264-8663
Addresses
Street Address
1805 Sinclair Avenue
Steubenville, OH 43952
Billing Address
Trinity Hospital Holding Company
4000 Johnson Road
Steubinville, OH 43952
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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