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DSH510006T UNITED HOSPITAL CENTER (Active)
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Main Details
Name
UNITED HOSPITAL CENTER
Subdivision Name
UHC Thoracic Surgery - Thoracic Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH510006T
Medicare Provider Number
510006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/25/2019
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
United Hospital Center
James Rutkowski, VP Finance/CFO
(681) 342-1605
Primary Contact
United Hospital Center
Carlton K. Hoskinson Jr., Director
(681) 342-1560
Addresses
Street Address
527 Medical Park Drive
Suite 108
Bridgeport, WV 26330
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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