340B Drug Pricing Program Database
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DSH510007AE ST. MARYS MEDICAL CENTER INC. (Terminated)
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Main Details
Name
ST. MARYS MEDICAL CENTER INC.
Subdivision Name
HIMG PAIN MANAGEMENT - Pain Management
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510007AE
Medicare Provider Number
510007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/31/2022
Last Recertification Date
8/25/2022
Termination Date
Termination Reason
7/1/2023
Business decision by the Covered Entity
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 C310
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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May 2025
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