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DSH510013E REYNOLDS MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
REYNOLDS MEMORIAL HOSPITAL
Subdivision Name
Internal Medicine - St. Clairsville 90.17 - Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510013E
Medicare Provider Number
510013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/29/2023
Last Recertification Date
8/13/2024
Termination Date
Termination Reason
10/1/2024
Site closure
Contacts
Authorizing Official
Reynolds Memorial Hospital
Alex Craig Inclan, CFO
(304) 843-3240
Primary Contact
Reynolds Memorial Hospital
Terry Kennon, Director of Pharmacy
(304) 843-3309
Addresses
Street Address
300 W Main St
St. Clairsville, OH 43950
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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