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CAH511322-00 West Virginia Health Care Cooperative, Inc. DBA Summersville Regional Medical Center (Active)
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Main Details
Name
West Virginia Health Care Cooperative, Inc. DBA Summersville Regional Medical Center
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH511322-00
Medicare Provider Number
511322
Additional Details
Current Program Status
Active
Registration Date
4/10/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/11/2019
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Summersville Regional Medical Center
John Timothy Lewis, COO
(304) 872-2891
Primary Contact
Summersville Regional Medical Center
Teresa Denise Taylor, 340B Director
(304) 872-8481
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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