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CAH511313-03 BOONE MEMORIAL HOSPITAL (Active)
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Main Details
Name
BOONE MEMORIAL HOSPITAL
Subdivision Name
Boone Memorial Hospital Specialty Clinic - Dermatology
Type
Critical Access Hospital
Rural
No
340B ID
CAH511313-03
Medicare Provider Number
511313
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/21/2021
Last Recertification Date
9/8/2024
Contacts
Authorizing Official
Boone Memorial Hospital Inc.
Virgil Lee Underwood, CEO
(304) 369-1230 Ext: 5507
Primary Contact
Boone Memorial Hospital
Angela Christian, Executive Director of Ancillary Services
(304) 369-1230 Ext: 5517
Addresses
Street Address
300 Fourth Street
Madison
Danville, WV 25053
Billing Address
Boone Memorial Hospital, Inc.
701 Madison Avenue
Madison, WV 25130
Comments
Medicaid Billing
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