NPIMap

Organization Active NPI

Charleston Area Medical Center, Inc.

Doing business as CAMC Pharmacy #3

  • Community/Retail Pharmacy
  • Charleston, WV
National Provider Identifier
1134518186
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
MP0552417 Issued in WV
Legal business name
CHARLESTON AREA MEDICAL CENTER, INC.
Doing business as
CAMC Pharmacy #3
Practice address
3415 Maccorkle Ave SE
Charleston, WV 25304-1334
Phone
(304) 388-9700
Fax
(304) 388-9795
NPI assigned
Jan 14, 2015
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chad Hovis
Title
VP Finance
Phone
(304) 388-6251

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X MP0552417 WV Primary

Addresses

Primary practice location

3415 Maccorkle Ave SE
Charleston, WV 25304-1334

Mailing address

3415 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-9700

Other identifiers 1

IdentifierTypeStateIssuer
2149739OtherPK

Other names 1

  • CAMC Pharmacy #3 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071210000438 WV Part A Provider - Hospital 3375441637 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20230727001336 WV Part B Supplier - Pharmacy 3375441637 1 other NPI on this enrollment
Practice locations: Charleston, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134518186. Details of each certification follow.

Hospital certification: CCN 510022

Legal name
CHARLESTON AREA MEDICAL CENTER INC
Doing business as
VANDALIA HEALTH CHARLESTON AREA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 1, 1972
Last certification
Apr 11, 2014
Beds
908
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1972 in WV
Enrollment address
501 Morris St
Charleston, WV 25301-1326
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Charleston Area Medical CenterCCN 510022 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John R Hoblitzell Individual Corporate DirectorMember Board of Trustees Apr 28, 2004
Melvin Jones Individual Corporate DirectorMember of Board of Trustees Jan 1, 2016
Ken Tackett Individual Corporate DirectorMember Board of Trustees Jan 1, 2012
Edwin Welch Individual Corporate DirectorMember Board of Trustees Jan 1, 1993
Fonda Elliot Individual Corporate DirectorMember Board of Trustees Jan 1, 2012
Glenn Crotty Individual Corporate DirectorChief Operating Officer Mar 28, 2004
W-2 Managing Employee Mar 28, 2004
David L Ramsey Individual 5% Or Greater Indirect Ownership InterestPresident and Ceo Sep 1, 2000 40%
Corporate OfficerPresident and Ceo Sep 1, 2000
Corporate DirectorPresident and Ceo Sep 1, 2000
W-2 Managing Employee Sep 1, 2000
Operational/Managerial ControlPresident and Ceo Sep 1, 2000
Mark a Chandler Individual Corporate DirectorMember Board of Trustees Jan 24, 2007
Chad Hovis Individual W-2 Managing EmployeeVP of Finance Sep 1, 2022
James Robert Campbell Individual Corporate DirectorChief of Staff Jan 1, 2023
Vandalia Health Inc Organization, Charleston, WV Corporation, Medical provider/supplier, Medical staffing company, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%
Operational/Managerial Control Sep 1, 2022 100%
Jeffrey D Sandene Individual Corporate DirectorExecutive VP and Cfo Dec 1, 2023
W-2 Managing EmployeeExecutive VP and Cfo Dec 1, 2023
Charles Capito Individual Corporate DirectorMember Board of Trustees Jan 1, 2011
Karen Price Individual Corporate DirectorMember Board of Trustees Feb 25, 2009
Stefan R Maxwell Individual Corporate DirectorMember Board of Trustees Jan 1, 2021
Eric a Hicks Individual Corporate DirectorMember Board of Trustees Jan 1, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Camc Charleston Surgical HospitalCharleston, WV, CCN 510091 Hospital 5% Or Greater Direct Ownership Interest (69.49%) Oct 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 1,621

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,621

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1134518186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-9700",
            "fax_number": "304-388-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041334",
            "telephone_number": "304-388-9700",
            "fax_number": "304-388-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON AREA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "HOVIS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "304-388-6251"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "MP0552417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149739",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMC Pharmacy #3",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAMC Pharmacy #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.