340B Drug Pricing Program Database
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DSH510007AC ST. MARYS MEDICAL CENTER INC. (Terminated)
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Main Details
Name
ST. MARYS MEDICAL CENTER INC.
Subdivision Name
HIMG OPHTHALMOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510007AC
Medicare Provider Number
510007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/31/2022
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
7/1/2024
Site closure
Contacts
Authorizing Official
St. Mary's Medical Center
Aaron C Blevins, Chief Pharmacy Officer
(304) 526-8250
Primary Contact
St. Mary's Medical Center
Kathy Walker, 340B Program Coordinator
(304) 526-8748
Addresses
Street Address
5170 US60 E
STE D255
HUNTINGTON, WV 25705
Billing Address
St. Mary's Medical Center Inc.
2900 First Avenue
Huntington, WV 25702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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