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DSH510022FQ CHARLESTON AREA MEDICAL CENTER (CAMC) (Active)
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Main Details
Name
CHARLESTON AREA MEDICAL CENTER (CAMC)
Subdivision Name
Rheumatology - CAMC Rheumatology TV
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH510022FQ
Medicare Provider Number
510022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/29/2023
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
CAMC Health System
Jeff D Sandene, EVP CFO
(304) 388-7603
Primary Contact
Vandalia Health
Brian Sayre, VP of Pharmacy Services
(304) 388-8917
Addresses
Street Address
1401 Hospital Drive
Suite 304
Hurricane, WV 25526
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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