340B Drug Pricing Program Database
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DSH360008BD SOUTHERN OHIO MEDICAL CENTER (Terminated)
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Main Details
Name
SOUTHERN OHIO MEDICAL CENTER
Subdivision Name
Waverly Family Health Center - Ultrasound
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH360008BD
Medicare Provider Number
360008
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2021
Participating Start Date
10/1/2021
Participating Approval Date
8/18/2021
Last Recertification Date
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
Southern Ohio Medical Center
Kara Plummer, Associate CFO, Administration
(740) 356-8880
Primary Contact
Southern Ohio Medical Center
Karen Elaine McGinnis, 340B Program Manager
(740) 356-6417
Addresses
Street Address
835 West Emmitt Avenue
Waverly, OH 45690
Billing Address
Southern Ohio Medical Center
1248 Kinneys Lane
Portsmouth, OH 45662
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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