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RRC360147-87 MARIETTA MEMORIAL HOSPITAL (Active)
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Main Details
Name
MARIETTA MEMORIAL HOSPITAL
Subdivision Name
Department of Rheumatology Belpre - Rheumatology Belpre
Type
Rural Referral Center
Rural
Yes
340B ID
RRC360147-87
Medicare Provider Number
360147
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/5/2023
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
807 Farson Street Suite 204 C
Belpre, OH 45714
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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