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RRC510023-00 WEIRTON MEDICAL CENTER (Terminated)
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Main Details
Name
WEIRTON MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC510023-00
Medicare Provider Number
510023
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2020
Participating Start Date
1/1/2021
Participating Approval Date
12/1/2020
Last Recertification Date
8/31/2021
Termination Date
Termination Reason
1/1/2022
DSH percentage below statutory minimum
Contacts
Authorizing Official
Weirton Medical Center
Joseph Sayut, Chief FInancial Officer
(304) 797-6511
Primary Contact
Weirton Medical Center
Robert Coram, Pharmacy Director
(304) 797-6069
Addresses
Street Address
601 COLLIERS WAY
WEIRTON, WV 26062
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (10/1/2019) until terminated effective date: (07/01/2020), reinstatement effective date: (01/01/2021)
11/30/2020
May 2025
May 2025
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