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RRC360147-79 MARIETTA MEMORIAL HOSPITAL (Active)
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Main Details
Name
MARIETTA MEMORIAL HOSPITAL
Subdivision Name
MARIETTA MEMORIAL HOSPITAL - PRIMARY CARE
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360147-79
Medicare Provider Number
360147
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/13/2022
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Marietta Memorial Hospital
Doug Full, Director of Finance
(740) 374-1698
Primary Contact
Marietta Memorial Hospital
David Layne, 340B Pharmacy Analyst
(606) 922-3796
Addresses
Street Address
800 PIKE ST
STE 2
MARIETTA, OH 45750-3507
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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