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WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
DSH510013 REYNOLDS MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
REYNOLDS MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510013
Entity Address
800 WHEELING AVENUE
GLEN DALE, WV 26038
Medicare Provider Number
510013
Participating Start Date
7/1/2021
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
Pharmacy Address
WVUH SPECIALTY PHARMACY & HOME INFUSION
3040 UNIVERSITY AVE STE 1400
MORGANTOWN, WV 26505
Pharmacy Comments
Contract Details
Approval Date
12/5/2023
Contract Begin Date
12/16/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alex Craig Inclan, CFO
(304) 843-3240
Contract Pharmacy Representative
WVU Medicine
Louis Sokos, Director of Pharmacy
(304) 598-4578
Signed By Date
12/5/2023
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