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WVU MedicineEmployee Benefit PlanTier 2The Health Plan1110 Main StreetWheeling, WV 260031.888.847.7902H5151 HMO15 050 R1; CMS Accepted 1/26/2015DISCLAIMER: The Health Plan has made every effort to be sure that this list of providers is up-to-date and correct. Please make sure the provider ison our network before you make an appointment. You can ask the provider. You can also ask our Customer Service. You can then be sure that he/she is still a part of our network. Members should refer to their Member Handbook for benefits. Call our Customer Service to see if the provider typeis covered. Feel free to ask if the treatment you need from a network provider is covered. Neither The Health Plan nor its Licensees are liable for anylosses, damages, or uncovered charges because of using this listing.
HELPFUL INFORMATION WHEN USING THIS PROVIDER DIRECTORYThis directory lists physicians, hospitals and otherhealthcare facilities/providers that are contractedwith The Health Plan as of the date this directory wasprinted. Please take some time to familiarize yourselfwith the directory, and contact The Health Plan, yourself-funded benefits administrator, with any questionsyou may have.1. PRIMARY CARE PHYSICIANS (PCP): Whether ornot your plan requires you to identify a PCPon your enrollment application, a PCP is thedoctor you choose from our network to providebasic healthcare. Depending on your plan, yourPCP may also be responsible for providing orauthorizing additional covered services underyour in-network benefits. Please refer to thesection entitled “Primary Care Physicians” for acomplete listing of PCPs with their addresses andphone numbers. If you are required to select a PCP,selections can be changed once per calendar month. Ifyou have any questions regarding the professionalqualifications of any participating physician pleasecontact The Health Plan’s Provider RelationsDepartment at 1.800.624.6961, ext. 7901.Non-Physician Practitioners can be Listed as aPCPCertified Nurse Practitioners2. SPECIALTY CARE PHYSICIANS: A Specialty CarePhysician, or SCP, is a doctor who provideshealthcare services for a specific disease or partof the body. Depending on your plan, a referralfrom your PCP may be required to access servicesfrom an SCP under your in-network benefits.Please refer to the section entitled “Specialist” for acomplete listing of SCPs with their addresses andphone numbers.Non-Physician Practitioner can be listed as yourSecondary Care ProviderCertified Nurse Midwife3. N. ETWORK HOSPITAL: A Network Hospital is afacility that is contracted with The Health Plan toprovide healthcare services to self-funded planparticipants and their dependents. The hospitallisting includes abbreviations for each hospital.These abbreviations appear in both the PCP andSCP listings, indicating at which hospital(s) thephysician has privileges. If you prefer a specifichospital, make sure the PCP or SCP you selecthas privileges at this hospital. Please refer tothe listing of “Participating Hospitals” for anexplanation of the abbreviation used for eachhospital.4. ANCILLARY SERVICES: Ancillary Services arehealthcare services provided by contractedproviders. These providers include ambulatorysurgery centers, durable medical equipmentsuppliers, home healthcare providers, laboratoryservices, skilled nursing and rehabilitationfacilities, urgent care centers and more.PLEASE NOTE: Although this directory is reprintedon an ongoing basis, provider changes occur daily.To verify accuracy of information, consider callingthe provider’s office directly or our Customer ServiceDepartment for further assistance, or you may visitour website at healthplan.org.
HELPFUL INFORMATION WHEN USING THIS PROVIDER DIRECTORYThe providers included in this directory arebased upon your listed county of residence andincludes your county and adjacent counties. Fora complete listing of all Health Plan providers,please refer to our website at healthplan.org orcall our our Customer Service Department atthe number below.CUSTOMER SERVICE1.888.847.79021.800.622.3925 (TDD/TTY)SYMBOLS TO KNOW# Accredited Hospital* Board Certified in the specialty indicated@ Foreign Language spoken% Cultural Competency Training Complete(T2) Tier 2 FacilitiesSection 1:Section 2:Section 3:Section 4:Section 5:Section 6:Section 7:Section 8:Section 9:Section 10:Section 11:TABLE OF CONTENTSParticipating HospitalsTertiary ProvidersPrimary Care PhysiciansNon-Physician Primary Care PractitionersSecondary Care PhysiciansNon-Physician Secondary Care PractitionersSpecialistsBehavioral Medicine & Psychiatry FacilitiesBehavioral Medicine & PsychiatryAncillary ServicesIndexThe following services under the WVU MedicineEmployee Benefits Plan will have cost-sharing thatis determined by a tiered (Tier 1/Tier 2) provider/facility network: Inpatient Hospital Physician Services Outpatient Diagnostic Procedures, Tests Outpatient Diagnostic Radiological Services Outpatient X-Rays Services Outpatient Hospital Services Outpatient Rehabilitation Services (Occupational,Physical, and Speech Therapy) Ambulatory Surgical Centers (ASC) ServicesHere is how your coverage will work for theseservices: Members will pay Tier 1 cost-sharing for the aboveservices at any WVU Medicine affiliated provider orfacility. Members will pay Tier 2 cost-sharing for the aboveservice at any non-Tier 1 contracted provider orfacility listed in this directory.Tier 1 providers/facilities will have (T1) listed aftertheir name in this Provider Directory.Tier 2 facilities will be all other facilities listed in thisProvider Directory.Please refer to your Evidence of Coverage (EOC) formore information on the cost-sharing for each tier.
Section 1Participating HospitalsAmbulatory SurgeryCentersALLEGANY COUNTY, MDAMBULATORY UROLOGYSURGICAL CTR (T2) #12234 WILLIAMS RD SECUMBERLAND, MD 21502301 724-0132SURGEONS SURGICALCENTER (T2) #940 SETON DRCUMBERLAND, MD 21502301 777-2543www.treatingpain.comALLEGHENY COUNTY, PADERMATOLOGY &COSMETIC SURGERYCENTER (T2) #PNC BANK BUILDING100 N WREN DRPITTSBURGH, PA 15243412 429-0276ATHENS COUNTY, OHHOLZER ATHENS (T2)2131 E STATE STATHENS, OH 45701740 589-3100BELMONT COUNTY, OHDIGESTIVE HEALTHCOMPLEX (T2)300 W MAIN STSAINT CLAIRSVILLE, OH43950740 968-7147VALLEY ENDOSCOPYCENTER (T2) #68377 STEWART DR STE202SAINT CLAIRSVILLE, OH43950304 242-7106WHEELING HOSPITALAMBULATORY SURGERYCTR (T2)68 STATE ROUTE 7BRIDGEPORT, OH 43912740 676-6600BERKELEY COUNTY, WVTRI-STATE SURGICALCENTER LLC (T2) #1006 TAVERN RDMARTINSBURG, WV 25401304 267-0556COLUMBIANA COUNTY,OHGI PHYSICIANSENDOSCOPY INC (T2) #235 E STATE ROUTE 14COLUMBIANA, OH 44408330 892-7400CUYAHOGA COUNTY, OHCLEVELAND EYE &LASER SURGERYCENTER (T2) #22715 FAIRVIEW CENTERDRFAIRVIEW PARK, OH 44126440 777-8400www.clevelandeyelaser.comFRANKLIN COUNTY, OHWHITE FENCE SURGICALSUITES (T2) #7277 SMITHS MILL RD STE300NEW ALBANY, OH 43054614 289-6282FREDERICK COUNTY, MDASC DEVELOPMENTCOMPANY LLC (T2) #75 THOMAS JOHNSON DRSTE CFREDERICK, MD 21702301 620-0012www.treatingpain.comFREDERICK COUNTY, VAVALLEY HEALTHSURGERY CENTER (T2) #174 BOTANICAL BLVDWINCHESTER, VA 22603540 536-2504GALLIA COUNTY, OHHOLZER GALLIPOLIS (T2)100 JACKSON PIKEGALLIPOLIS, OH 45631740 446-5000Date Created: 7/29/2020% Cultural Competency Training CompleteGREENBRIER COUNTY,WVGREENBRIER CLINICSURGERY CENTER (T2) #40823 MIDLAND TRL EWHITE SULPHURSPRINGS, WV 24986304 536-4870GREENE COUNTY, PASOUTHWESTERN PA EYESURGERY CENTER (T2) #236 ELM DR STE 103WAYNESBURG, PA 15370724 627-5383JACKSON COUNTY, OHHOLZER JACKSON (T2)280 PATTONSVILLE RDJACKSON, OH 45640JEFFERSON COUNTY, OHVALLEY ENDOSCOPYCENTER (T2) #100 WELDAY AVE STE DWINTERSVILLE, OH 43953740 699-2747VALLEY SURGERYCENTER (T2)2323 SUNSET BLVDSTEUBENVILLE, OH 43952740 264-0145www.valleysurgerycenter.comLICKING COUNTY, OHBLOOMBERG EYECENTER (T2) #1651 W MAIN STNEWARK, OH 43055740 522-3937CENTER FOR ADVANCEDEYE SURGERY (T2) #1031 W WESTERNRESERVE RDPOLAND, OH 44514330 965-0900LEE SURGERY CENTER(T2) #Ophthalmology Only8135 MARKET STYOUNGSTOWN, OH 44512330 758-0900MILL CREEK ENDOSCOPYSUITES (T2) #1210 BOARDMANCANFIELD RDYOUNGSTOWN, OH 44512330 399-7215THE ORTHOPAEDICSURGERY CTR (T2) #TOSC LLC6505 MARKET ST BLDG BSTE 101BOARDMAN, OH 44512330 758-1065THEORTHOSURGERYCENTER.COMMEDINA COUNTY, OHENDOSCOPY CENTER OFNORTHERN OHIO (T2) #1299 INDUSTRIAL PKWY NSTE 120BRUNSWICK, OH 44212330 225-6468www.mygidocs.comMAHONING COUNTY, OHSUMMA HEALTH CENTERAT WADSWORTHRITTMAN (T2)195 WADSWORTH RDWADSWORTH, OH 44281234 312-5700BELMONT EYE SURGERY(T2) #3020 BELMONT AVEYOUNGSTOWN, OH 44505330 759-7672THE MEDINA SURGERYCENTER (T2) #3780 MEDINA RD STE 120MEDINA, OH 44256330 952-0014www.bloombergeye.comwww.belmont eye clinicwww.healthplan.org- 1 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
MONONGALIA COUNTY,WVMON HEALTH CENTERFOR OUTPATIENTSURGERY (T2) #2000 MON HEALTHMEDICAL PARK DR STE2200MORGANTOWN, WV 26505304 413-2200SURGICAL EYE CENTEROF MORGANTOWN (T2) #1299 PINEVIEW DRMORGANTOWN, WV 26505304 598-5777MONTGOMERY COUNTY,MDASC DEVELOPMENTCOMPANY LLC (T2) #11921 ROCKVILLE PIKESTE 505ROCKVILLE, MD 20852301 881-7246STARK COUNTY, OHEYE SURGICAL CENTERLLC (T2)800 MCKINLEY AVE NWCANTON, OH 44703330 639-0046dhcakron.comGASTROENTEROLOGYASSOC INC (T2) #4665 BELPAR ST NWCANTON, OH 44718330 493-1480NOVUS CLINIC (T2) #SYSTEM OPTICS518 WEST AVETALLMADGE, OH 44278330 ISTS INC (T2) #2726 FULTON DR NWCANTON, OH 44718330 455-5011www.gsiohio.comOASIS (T2) #4889 MUNSON ST NWCANTON, OH 44718330 498-9898www.treatingpain.comoasissurgery.comASC DEVELOPMENTCOMPANY LLC (T2) #19735 GERMANTOWN RDSTE 360GERMANTOWN, MD 20874301 528-2810STARK AMBULATORYSURGERY CENTER (T2) #4360 FULTON DR NW STECCANTON, OH 44718330 305-2020www.treatingpain.comwww.ghscanton.comASC DEVELOPMENTCOMPANY LLC (T2) #8455 COLESVILLE RD STE200SILVER SPRING, MD 20910301 588-0505SURGERY ALLIANCE (T2)#975 S SAWBURG AVEALLIANCE, OH 44601330 821-7997www.treatingpain.comMUSKINGUM COUNTY, OHINSIGHT SURGERY &LASER CENTER (T2) #3973 NORTHPOINTE DRZANESVILLE, OH 43701740 452-8200RALEIGH COUNTY, WVBECKLEY SURGERYCENTER INC (T2) #84 BROOKSHIRE LNBECKLEY, WV 25801304 255-2724VISTA SURGICAL CENTER(T2) #4319 EXECUTIVE CIR NWCANTON, OH 44718330 526-0530www.vistasurgicalcenter.comSUMMIT COUNTY, OHCOMPREHENSIVESURGICAL CENTER OFGREEN (T2) #1560 CORPORATEWOODS PKWYUNIONTOWN, OH 44685330 208-2720beckleysurgerycenter.comDIGESTIVE HEALTHCENTER LLC (T2) #570 WHITE POND DR STE150AKRON, OH 44320330 869-0178WWW.NOVUSCLINIC.COMPARK WEST SURGICALCTR (T2) #1 PARK WEST BLVD STE260AKRON, OH 44320330 864-6000SAINT CLARE SURGERYCENTER (T2)4441 HUDSON DRSTOW, OH 44224330 920-4500SURGERY CENTER ATAKRON GENERALHEALTH (T2) #& WELLNESS CTR4125 MEDINA RD STE 104AKRON, OH 44333330 665-8000THE CENTER FORSURGERY (T2) #Ophthalmology Only789 GRAHAM RDCUYAHOGA FALLS, OH44221330 923-5676www.daviseyecenter.comTAZEWELL COUNTY, VAREGIONAL SURGICALSERVICES (T2) #234 MEDICAL PARK DRSTE 100BLUEFIELD, VA 24605276 322-2223TRUMBULL COUNTY, OHAVAMAR CENTER FORENDOSCOPY (T2) #9225 E MARKET STWARREN, OH 44484330 372-7470GYPSY LANEENDOSCOPY SUITES (T2)#JALOMAR BLDG630 GYPSY LNYOUNGSTOWN, OH 44505330 743-9255LIPPY SURGERY CENTER(T2) #NORTHMAR II3893 E MARKET STWARREN, OH 44484330 856-1272ST JOSEPH SURGERYCENTER (T2) #HOWLAND SURGERYCENTER1934 NILES CORTLANDRD NEWARREN, OH 44484330 609-7874STEWARD TRUMBULLMEMORIAL (T2) #CENTER FOR SURGERY2580 STATE ROUTE 5BLDG ACORTLAND, OH 44410330 841-1011WARRENGASTROINTESTINALENDOSCOPY CTR (T2) #1622 E MARKET STWARREN, OH 44483330 399-7215TUSCARAWAS COUNTY,OHTUSCARAWASAMBULATORY SURGERYCENTER (T2) #320 OXFORD STDOVER, OH 44622330 365-2101WASHINGTON COUNTY,MDASC DEVELOPMENTCOMPANY LLC (T2) #1150 PROFESSIONAL CTSTE PHAGERSTOWN, MD 21740301 logy.comDate Created: 7/29/2020% Cultural Competency Training Completewww.healthplan.org- 2 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
WASHINGTON COUNTY,OHMARIETTA SURGERYCENTER (T2)611 2ND ST STE BMARIETTA, OH 45750740 373-7207PHYSICIANS OUTPATIENTSURGERY CENTER (T2)1933 WASHINGTON BLVDBELPRE, OH 45714888 547-1222www.theeyemds.comWASHINGTON COUNTY,PASOUTHWESTERN PA EYESURGERY CENTER (T2) #750 E BEAU STWASHINGTON, PA 15301724 228-7477TRI-STATE SURGERYCENTER (T2) #80 LANDINGS DR STE 101WASHINGTON, PA 15301724 225-8800www.tri-statesurgery.comWAYNE COUNTY, OHCCF WOOSTEROUTPATIENT SURGERYCENTER (T2) #721 E MILLTOWN RDWOOSTER, OH 44691330 287-4500EYE SURGERY CENTEROF WOOSTER (T2) #3519 FRIENDSVILLE RDWOOSTER, OH 44691330 345-6371BOONE COUNTY, WVHOCKING COUNTY, OHBOONE MEMORIALHOSPITAL (T2) #701 MADISON AVEMADISON, WV 25130304 369-1230HOCKING VALLEY COMMHOSPITAL (T2) #601 STATE ROUTE 664 NPO BOX 966LOGAN, OH 43138740 380-8000SHENANDOAH COUNTY,VASHENANDOAH MEMORIALHOSPITAL (T2) #759 S MAIN STWOODSTOCK, VA 22664540 459-1100JACKSON COUNTY, OHSUMMERS COUNTY, WVHOLZER MEDICALCENTER JACKSON (T2) #500 BURLINGTON RDJACKSON, OH 45640855 446-5937SUMMERS COUNTY ARHHOSPITAL (T2) #115 SUMMERS HOSPITALRDHINTON, WV 25951304 466-1000CALHOUN COUNTY, WVMINNIE HAMILTONHEALTH SYSTEM (T2)186 HOSPITAL DRGRANTSVILLE, WV 26147304 354-9244FAYETTE COUNTY, WVMONTGOMERY GENERALHOSPITAL (T2) #401 6TH AVEMONTGOMERY, WV 25136304 442-5151PLATEAU MEDICALCENTER (T2) #430 MAIN ST EOAK HILL, WV 25901304 469-8600WAR MEMORIALHOSPITAL (T2) #1 HEALTHY WAYBERKELEY SPRINGS, WV25411304 258-1234GALLIA COUNTY, OHHOLZER MEDICALCENTER (T2) #100 JACKSON PIKEGALLIPOLIS, OH 45631740 446-5000PAGE COUNTY, VAGRANT COUNTY, WVGRANT MEMORIALHOSPITAL (T2)117 HOSPITAL DRPETERSBURG, WV 26847304 257-1026HAMPSHIRE COUNTY, WVCritical AccessFacilityBARBOUR COUNTY, WVHARRISON COUNTY, OHBROADDUS HOSPITAL(T2)1 HEALTHCARE DRPHILIPPI, WV 26416304 457-1760HARRISON COMMUNITYHOSPITAL INC (T2) #951 E MARKET STCADIZ, OH 43907740 942-4631BELMONT COUNTY, OHBARNESVILLE HOSPITAL(T2) #%639 W MAIN STBARNESVILLE, OH 43713740 425-3941Date Created: 7/29/2020% Cultural Competency Training CompleteLODI COMMUNITYHOSPITAL (T2) #225 ELYRIA STLODI, OH 44254330 948-1222MORGAN COUNTY, WVHAMPSHIRE MEMORIALHOSPITAL (T2) #363 SUNRISE BLVDROMNEY, WV 26757304 822-4561www.woostereyecenter.comMEDINA COUNTY, OHPAGE MEMORIALHOSPITAL (T2) #200 MEMORIAL DRLURAY, VA 22835540 743-4561POCAHONTAS COUNTY,WVPOCAHONTAS MEMORIALHOSPITAL (T2)150 DUNCAN RDBUCKEYE, WV 24924304 799-7400PRESTON COUNTY, WVPRESTON MEMORIALHOSPITAL (T2)150 MEMORIAL DRKINGWOOD, WV 26537304 329-1400www.prestonmemorial.orgROANE COUNTY, WVROANE GENERALHOSPITAL (T2) #200 HOSPITAL DRSPENCER, WV 25276304 927-4444SUMMIT COUNTY, OHMICHAEL A PASSERO MD(T2)CLEVELAND CLINICFOUNDATION200 E MARKET STAKRON, OH 44308216 444-6503TAYLOR COUNTY, WVGRAFTON CITY HOSPITAL(T2)ATTN MEDICAL STAFFCOORDINATOR1 HOSPITAL PLZGRAFTON, WV 26354304 265-0400TUSCARAWAS COUNTY,OHTRINITY HOSPITAL TWINCITY (T2) #819 N 1ST STDENNISON, OH 44621740 922-2800TYLER COUNTY, WVSISTERSVILLE GENERALHOSPITAL (T2)314 S WELLS STSISTERSVILLE, WV 26175304 652-2611WASHINGTON COUNTY,OHSELBY GENERALHOSPITAL (T2) #1106 COLEGATE DRMARIETTA, OH 45750740 568-2000www.healthplan.org- 3 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
WAYNE COUNTY, OHAULTMAN ORRVILLEHOSPITAL (T2) #832 S MAIN STORRVILLE, OH 44667330 682-3010Dialysis CentersALLEGHENY COUNTY, PAAVONWORTH DIALYSIS(T2)259 MOUNT NEBO POINTERDPITTSBURGH, PA 15237412 364-3238CABELL COUNTY, WVHospitalsALLEGHENY COUNTY, PAHERITAGE VALLEYSEWICKLEY (T2) #720 BLACKBURN RDSEWICKLEY, PA 15143412 741-6600WWW.HERITAGEVALLEY.ORGASHLAND COUNTY, OHWWW.DAVITA.COMUH SAMARITAN MEDICALCENTER (T2) #1025 CENTER STASHLAND, OH 44805419 289-0491CRAWFORD COUNTY, PABARBOUR COUNTY, WVFRENCH CREEK DIALYSIS(T2)991 PARK AVEMEADVILLE, PA 16335814 336-2531BROADDUS HOSPITAL(T2)1 HEALTHCARE DRPHILIPPI, WV 26416304 457-1760www.davita.comBEAVER COUNTY, PAPORTAGE COUNTY, OHHERITAGE VALLEYBEAVER (T2) #1000 DUTCH RIDGE RDBEAVER, PA 15009724 728-7000US RENAL CARE KENTDIALYSIS (T2)1720 E MAIN ST STE BKENT, OH 44240330 346-0467SUMMIT COUNTY, OHWWW.HERITAGEVALLEY.ORGUS RENAL CAREBARBERTON DIALYSIS(T2)33 3RD ST SE STE 100BARBERTON, OH 44203330 753-7280BELMONT COUNTY, OHUS RENAL CARECUYAHOGA FALLSDIALYSIS (T2)421 PORTAGE TRL STE BCUYAHOGA FALLS, OH44221330 928-7970BOONE COUNTY, WVUS RENAL CARE NORTONHOME THERAPIES LLC(T2)3300 GREENWICH RD STE13NORTON, OH 44203330 825-2354KINGS DAUGHTERSMEDICAL CENTER (T2) #2201 LEXINGTON AVEASHLAND, KY 41101606 408-4000BARNESVILLE HOSPITAL(T2) #%639 W MAIN STBARNESVILLE, OH 43713740 425-3941WEIRTON MEDICALCENTER (T2) #601 COLLIERS WAYWEIRTON, WV 26062304 797-6000Date Created: 7/29/2020% Cultural Competency Training CompleteGALLIA COUNTY, OHHOLZER MEDICALCENTER (T2) #100 JACKSON PIKEGALLIPOLIS, OH 45631740 446-5000CALHOUN COUNTY, WVGRANT COUNTY, WVMINNIE HAMILTONHEALTH SYSTEM (T2)186 HOSPITAL DRGRANTSVILLE, WV 26147304 354-9244GRANT MEMORIALHOSPITAL (T2)117 HOSPITAL DRPETERSBURG, WV 26847304 257-1026COLUMBIANA COUNTY,OHEAST LIVERPOOLHOSPITAL (T2) #425 W 5TH STEAST LIVERPOOL, OH43920330 385-7200GREENBRIER COUNTY,WVGREENBRIER VALLEYMEDICAL CENTER (T2) #202 MAPLEWOOD AVERONCEVERTE, WV 24970304 647-4411SALEM REGIONALMEDICAL CENTER (T2) #1995 E STATE STSALEM, OH 44460330 332-1551WASHINGTON HEALTHSYSTEM GREENE (T2)370 BONAR AVEWAYNESBURG, PA 15370724 627-3101COSHOCTON COUNTY,OHCOSHOCTON REGIONALMEDICAL CENTER (T2) #1460 ORANGE STCOSHOCTON, OH 43812740 FAIRFIELD COUNTY, OHBOYD COUNTY, KYPLATEAU MEDICALCENTER (T2) #430 MAIN ST EOAK HILL, WV 25901304 469-8600ST MARYS HOSPITAL (T2)#2900 1ST AVEHUNTINGTON, WV 25702304 526-1234WWW.PRIMEHEALTHCARE.COMBOONE MEMORIALHOSPITAL (T2) #701 MADISON AVEMADISON, WV 25130304 369-1230BROOKE COUNTY, WVCABELL HUNTINGTONHOSPITAL (T2) #1340 HAL GREER BLVDHUNTINGTON, WV 25701304 526-2000FAIRFIELD MEDICALCENTER (T2) #401 N EWING STLANCASTER, OH 43130740 687-8000www.fmchealth.orgFAYETTE COUNTY, WVMONTGOMERY GENERALHOSPITAL (T2) #401 6TH AVEMONTGOMERY, WV 25136304 442-5151GREENE COUNTY, PAGUERNSEY COUNTY, OHSOUTHEASTERN OHIOREGIONAL MED CTR (T2)#%1341 CLARK STCAMBRIDGE, OH 43725740 439-3561HAMPSHIRE COUNTY, WVHAMPSHIRE MEMORIALHOSPITAL (T2) #363 SUNRISE BLVDROMNEY, WV 26757304 822-4561HARRISON COUNTY, OHHARRISON COMMUNITYHOSPITAL INC (T2) #951 E MARKET STCADIZ, OH 43907740 942-4631www.healthplan.org- 4 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
HOCKING COUNTY, OHHOCKING VALLEY COMMHOSPITAL (T2) #601 STATE ROUTE 664 NPO BOX 966LOGAN, OH 43138740 380-8000HOLMES COUNTY, OHPOMERENE HOSPITAL(T2) #981 WOOSTER RDMILLERSBURG, OH 44654330 674-1584HURON COUNTY, OHFISHER TITUS MEDICALCENTER (T2) #272 BENEDICT AVENORWALK, OH 44857419 668-8101fishertitus.orgJACKSON COUNTY, OHHOLZER MEDICALCENTER JACKSON (T2) #500 BURLINGTON RDJACKSON, OH 45640855 446-5937JEFFERSON COUNTY, OHTRINITY MEDICALCENTER WEST (T2) #4000 JOHNSON RDSTEUBENVILLE, OH 43952740 264-8000KANAWHA COUNTY, WVCAMC GENERALHOSPITAL (T2) #%501 MORRIS STCHARLESTON, WV 25301304 388-5432CAMC MEMORIALHOSPITAL (T2) #%3200 MACCORKLE AVE SECHARLESTON, WV 25304304 388-5432CAMC WOMEN &CHILDRENS HOSPITAL(T2) #%800 PENNSYLVANIA AVECHARLESTON, WV 25302304 388-5432CHARLESTON HOSPITALINC (T2) #SAINT FRANCISHOSPITAL333 LAIDLEY STCHARLESTON, WV 25301304 347-6500CHARLESTON SURGICALHOSPITAL INC (T2) #1306 KANAWHA BLVD ECHARLESTON, WV 25301304 343-4371THOMAS MEMORIALHOSPITAL (T2) #4605 MACCORKLE AVESWSOUTH CHARLESTON, WV25309304 766-3600LAWRENCE COUNTY, OHTHREE GABLESSURGERY CENTER (T2) #5897 COUNTY ROAD 107PROCTORVILLE, OH 45669740 886-9911LEWIS COUNTY, WVSTONEWALL JACKSONMEMORIAL HOSPITAL(T2) #%230 HOSPITAL PLZWESTON, WV 26452304 269-3000LOGAN COUNTY, WVLOGAN REGIONALMEDICAL CTR (T2) #20 HOSPITAL DRLOGAN, WV 25601304 831-1101MAHONING COUNTY, OHAKRON CHILDRENSHOSPITAL MAHONINGVALLEY (T2) #BEEGHLY MEDICAL PARK6505 MARKET STBOARDMAN, OH 44512330 746-8100ST ELIZABETHYOUNGSTOWN HOSPITAL(T2) #Adults OnlyMERCY HEALTHYOUNGSTOWN LLC1044 BELMONT AVEYOUNGSTOWN, OH 44504330 480-7211ST ELIZABETHYOUNGSTOWN HOSPITAL(T2) #MERCY HEALTHYOUNGSTOWN LLC1044 BELMONT AVEYOUNGSTOWN, OH 44504330 480-7211MASON COUNTY, WVPLEASANT VALLEYHOSPITAL (T2) #2520 VALLEY DRPOINT PLEASANT, WV25550304 675-4340MCDOWELL COUNTY, WVWELCH COMMUNITYHOSPITAL (T2)454 MCDOWELL STWELCH, WV 24801304 436-8461MEDINA COUNTY, OHLODI COMMUNITYHOSPITAL (T2) #225 ELYRIA STLODI, OH 44254330 948-1222MEDINA HOSPITAL (T2) #1000 E WASHINGTON STMEDINA, OH 44256330 725-1000MERCER COUNTY, WVPRINCETON COMMUNITYHOSPITAL (T2) #122 12TH STPRINCETON, WV 24740304 487-7000www.akronchildrens.orgMORGAN COUNTY, WVST ELIZABETHBOARDMAN HOSPITAL(T2) #8401 MARKET STBOARDMAN, OH 44512330 729-2929WAR MEMORIALHOSPITAL (T2) #1 HEALTHY WAYBERKELEY SPRINGS, WV25411304 258-1234Date Created: 7/29/2020% Cultural Competency Training CompleteMUSKINGUM COUNTY, OHGENESIS HOSPITAL (T2)#2951 MAPLE AVEZANESVILLE, OH 43701740 454-4000OHIO COUNTY, WVWHEELING HOSPITAL(T2) #%1 MEDICAL PARKWHEELING, WV 26003304 243-3000PAGE COUNTY, VAPAGE MEMORIALHOSPITAL (T2) #200 MEMORIAL DRLURAY, VA 22835540 743-4561PIKE COUNTY, KYPIKEVILLE MEDICALCENTER (T2) #911 BYPASS RDPIKEVILLE, KY 41501606 215-3500TUG VALLEY ARH REGMED CTR (T2) #260 HOSPITAL DRSOUTH WILLIAMSON, KY41503606 237-1700POCAHONTAS COUNTY,WVPOCAHONTAS MEMORIALHOSPITAL (T2)150 DUNCAN RDBUCKEYE, WV 24924304 799-7400PORTAGE COUNTY, OHUH PORTAGE MEDICALCENTER (T2) #6847 N CHESTNUT STRAVENNA, OH 44266330 297-0811PRESTON COUNTY, WVPRESTON MEMORIALHOSPITAL (T2)150 MEMORIAL DRKINGWOOD, WV 26537304 329-1400www.prestonmemorial.orgwww.healthplan.org- 5 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
PUTNAM COUNTY, WVCAMC TEAYS VALLEYHOSPITAL (T2) #%1400 HOSPITAL DRHURRICANE, WV 25526304 757-1700RALEIGH COUNTY, WVBECKLEY ARH HOSPITAL(T2) #306 STANAFORD RDBECKLEY, WV 25801304 255-3000RALEIGH GENERALHOSPITAL (T2) #1710 HARPER RDBECKLEY, WV 25801304 256-4100RANDOLPH COUNTY, WVDAVIS MEDICAL CENTER(T2) #812 GORMAN AVEELKINS, WV 26241304 636-3300ROANE COUNTY, WVROANE GENERALHOSPITAL (T2) #200 HOSPITAL DRSPENCER, WV 25276304 927-4444SCIOTO COUNTY, OHKINGS DAUGHTERSMEDICAL CENTER OHIO(T2) #1901 ARGONNE RDPORTSMOUTH, OH 45662740 991-4000STARK COUNTY, OHAKRON CHILDREN'S ATAULTMAN (T2) #2600 6TH ST SWCANTON, OH 44710330 543-0140www.akronchildrens.orgALLIANCE COMMUNITYHOSPITAL (T2) #200 E STATE STALLIANCE, OH 44601330 596-6000AULTMAN HOSPITAL (T2)#2600 6TH ST SWCANTON, OH 44710330 363-4000TYLER COUNTY, WVSUMMERS COUNTY, WVSUMMA ST THOMASHOSPITAL (T2) #Adults Only444 N MAIN STAKRON, OH 44310330 375-3000SUMMERS COUNTY ARHHOSPITAL (T2) #115 SUMMERS HOSPITALRDHINTON, WV 25951304 466-1000WESTERN RESERVEHOSPITAL (T2) #1900 23RD STCUYAHOGA FALLS, OH44223330 971-7000WARREN COUNTY, VASUMMIT COUNTY, OHTAYLOR COUNTY, WVAKRON CHILDRENSHOSPITAL (T2) #1 PERKINS SQAKRON, OH 44308330 543-1000GRAFTON CITY HOSPITAL(T2)ATTN MEDICAL STAFFCOORDINATOR1 HOSPITAL PLZGRAFTON, WV 26354304 265-0400WASHINGTON COUNTY,MDJOHN R MARSH CANCERCENTER (T2) #MERITUS CANCERSERVICE11110 MEDICAL CAMPUSRD STE 129HAGERSTOWN, MD 21742301 665-4650MERCY MEDICAL CENTER(T2) #1320 MERCY DR NWCANTON, OH 44708330 489-1000www.akronchildrens.orgAKRON GENERALMEDICAL CENTER (T2) #1 AKRON GENERAL AVEAKRON, OH 44307330 384-6100CRYSTAL CLINICORTHOPAEDIC CENTER(T2) #444 N MAIN STAKRON, OH 44310330 762-2262WWW.CRYSTALCLINIC.COMCRYSTAL CLINICORTHOPAEDIC CENTER(T2) #3975 EMBASSY PKWY STE202AKRON, OH 44333330 668-4040WWW.CRYSTALCLINIC.COMSUMMA AKRON CITYHOSPITAL (T2) #525 E MARKET STAKRON, OH 44304330 375-3000SUMMA BARBERTONHOSPITAL (T2) #155 5TH ST NEBARBERTON, OH 44203330 615-3000Date Created: 7/29/2020% Cultural Competency Training CompleteTRUMBULL COUNTY, OHCHILDREN'S AT STJOSEPH'S HOSPITAL (T2)#667 EASTLAND AVE SEWARREN, OH 44484330 543-1000www.akronchildrens.orgST JOSEPH WARRENHOSPITAL (T2) #Adults Only667 EASTLAND AVE SEWARREN, OH 44484330 841-4000STEWARD TRUMBULLMEMORIAL HOSPITAL(T2) #Adults Only1350 E MARKET STWARREN, OH 44483330 841-9011TUSCARAWAS COUNTY,OHCLEVELAND CLINICUNION HOSPITAL (T2) #659 BOULEVARD STDOVER, OH 44622330 343-3311TRINITY HOSPITAL TWINCITY (T2) #819 N 1ST STDENNISON, OH 44621740 922-2800SISTERSVILLE GENERALHOSPITAL (T2)314 S WELLS STSISTERSVILLE, WV 26175304 652-2611WARREN MEMORIALHOSPITAL (T2) #1000 N SHENANDOAH AVEFRONT ROYAL, VA 22630540 636-0300MERITUS MEDICALCENTER INC (T2) #11116 MEDICAL CAMPUSRDHAGERSTOWN, MD 21742240 313-9519WASHINGTON COUNTY,OHMARIETTA MEMORIALHOSPITAL (T2) #%401 MATTHEW STMARIETTA, OH 45750740 374-1400SELBY GENERALHOSPITAL (T2) #1106 COLEGATE DRMARIETTA, OH 45750740 568-2000WASHINGTON COUNTY,PAADVANCED SURGICALHOSPITAL (T2) #100 TRICH DR STE 1WASHINGTON, PA 15301724 884-0710www.ashospital.netWASHINGTON HOSPITAL(T2) #155 WILSON AVEWASHINGTON, PA 15301724 225-7000www.healthplan.org- 6 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
WAYNE COUNTY, OHAULTMAN ORRVILLEHOSPITAL (T2) #832 S MAIN STORRVILLE, OH 44667330 682-3010WOOSTER COMMUNITYHOSPITAL (T2) #1761 BEALL AVEWOOSTER, OH 44691330 263-8148www.woosterhospital.orgWEBSTER COUNTY, WVWEBSTER COUNTYMEMORIAL HOSPITAL(T2)324 MILLER MOUNTAINDRWEBSTER SPRINGS, WV26288304 847-5682www.wcmhwv.orgWINCHESTER CITYCOUNTY, VAWINCHESTER MEDICALCENTER (T2) #1840 AMHERST STWINCHESTER, VA 22601540 536-8000SELECT SPECIALTYHOSPITAL- PITTSBURGH(T2) #MUH E824 - 200 LOTHROP(UPMC)3485 FIFTH AVEPITTSBURGH, PA 15213412 comBELMONT COUNTY, OHACUITY SPECIALTYHOSPITAL OF OHIOVALLEY (T2) #4697 HARRISON ST FL 2BELLAIRE, OH 43906740 671-1438BROOKE COUNTY, WVACUITY SPECIALTYHOSPITAL OF OHIOVALLEY (T2) #601 COLLIERS WAY FL 9WEIRTON, WV 26062304 724-1172CABELL COUNTY, WVLong Term Acute CareHospitalsCORNERSTONESPECIALTY HOSPITALHUNTINGTO (T2) #2900 FIRST AVENUE TWOEASTHUNTINGTON, WV 25702304 399-2600ALLEGHENY COUNTY, PACUYAHOGA COUNTY, OHSELECT SPECIALTYHOSPITAL ALLE KISKI(T2) #1301 CARLISLE ST FL1A/1CNATRONA HEIGHTS, PA15065724 604-9001REGENCY HOSPITAL OFCLEVELAND EAST (T2) #4200 INTERCHANGECORPORATE CTRWARRENSVILLE HEIGHTS,OH 44128216 comSELECT SPECIALTYHOSPITAL- MCKEESPORT(T2) #1500 5TH AVE FL 6MCKEESPORT, PA 15132412 664-2935REGENCY HOSPITAL OFCLEVELAND WEST (T2) #6990 ENGLE RDMIDDLEBURG HEIGHTS,OH 44130440 202-4200SELECT SPECIALTYHOSPITAL (T2) #CLEVELAND FAIRHILL11900 FAIRHILL RDCLEVELAND, OH 44120216 983-8030FRANKLIN COUNTY, OHREGENCY HOSPCOLUMBUS EAST (T2) #181 TAYLOR AVECOLUMBUS, OH 43203614 459-9045REGENCY HOSPITAL OFCOLUMBUS SOUTH (T2) #1430 S HIGH STCOLUMBUS, OH 43207614 456-0300SELECT SPECIALTYHOSPITAL- COLUMBUS(T2) #1087 DENNISON AVECOLUMBUS, OH 43201614 458-9000KANAWHA COUNTY, WVSELECT SPECIALTYHOSPITAL- CHARLESTON(T2) #333 LAIDLEY ST FL 3CHARLESTON, WV 25301304 720-7234LICKING COUNTY, OHSELECT SPECIALTYHOSPITAL- ZANESVILLE(T2) #2000 TAMARACK RDNEWARK, OH 43055740 588-7888MAHONING COUNTY, OHSELECT SPECIALTYHOSP- YOUNGSTOWN(T2) #SELECT SPECIALTYHOSPITAL BOARDMAN8401 MARKET STBOARDMAN, OH 44512330 729-1750SELECT SPECIALTYHOSPITAL (T2) #CLEVELAND GATEWAY2351 E 22ND ST 7THFLOORCLEVELAND, OH 44115216 592-2175Date Created: 7/29/2020% Cultural Competency Training CompleteMONONGALIA COUNTY,WVACUITY SPECIALTYHOSPITAL OFMORGANTOWN (T2) #1200 J D ANDERSON DRFL 4MORGANTOWN, WV 26505855 281-5728www.acuityhealthcare.netOHIO COUNTY, WVACUITY SPECIALTYHOSPITAL OF OHIOVALLEY (T2) #1 MEDICAL PARKWHEELING, WV 26003304 243-3000STARK COUNTY, OHAULTMAN SPECIALTYHOSPITAL (T2) #2600 6TH ST SWCANTON, OH 44710330 363-4000SELECT SPECIALTYHOSPITAL- CANTON (T2)#1320 MERCY DR NWCANTON, OH 44708330 489-8198SUMMIT COUNTY, OHSELECT SPECIALTYHOSPITAL - AKRON (T2) #200 E MARKET STAKRON, OH 44308330 761-7500Skilled NursingFacilitiesALLEGHENY COUNTY, PAMONROEVILLE REHAB &WELLNESS (T2)4142 MONROEVILLE BLVDMONROEVILLE, PA 15146412 856-7570MT LEBANONREHABILITATION &WELLNESS (T2)350 OLD GILKESON RDPITTSBURGH, PA 15228412 257-4444www.healthplan.org- 7 -# Accredited hospitalNOTE: Provider List is subject to change. Please check website at www.healthplan.org or contact Customer Service at 1.800.624.6961 ifyou have questions or need further information regarding provider participating status.
ASHLAND COUNTY, OHBRETHREN CAREVILLAGE LLC (T2)2000 CENTER STASHLAND, OH 44805419 289-1585www.brethrencarevillage.orgKINGSTON OF ASHLAND(T2)20 AMBERWOOD PKWYASHLAND, OH 44805419 289-3859THE GOOD SHEPHERDREHABILITATION (T2)622 CENTER STASHLAND, OH 44805419 THENS COUNTY, OHARCADIA VALLEYSKILLED NURSING (T2)25675 MAIN STCOOLVILLE, OH 45723740 667-3156BELMONT COUNTY, OHASTORIA PLACE OFBARNESVILLE (T2)400 CARRIE AVEBARNESVILLE, OH 43713740 425-3648BELMONT MANOR INC(T2)51999 GUIRINO DRSAINT CLAIRSVILLE, OH43950740 695-4404CONTINUINGHEALTHCARE AT FORESTHILL (T2)100 RESERVOIR RDSAINT CLAIRSVILLE, OH43950740 695-7233CONTINUINGHEALTHCARE OFSHADYSIDE (T2)60583 STATE ROUTE 7SHADYSIDE, OH 43947740 676-8381COUNTRY CLUBREHABILITATIONCAMPUS BELLA (T2)COUNTRY CLUBRETIRE
BLOOMBERG EYE CENTER (T2) # 1651 W MAIN ST NEWARK, OH 43055 740 522-3937 www.bloombergeye.com MAHONING COUNTY, OH BELMONT EYE SURGERY (T2) # 3020 BELMONT AVE YOUNGSTOWN, OH 44505 330 759-7672 www.belmont eye clinic CENTER FOR ADVANCED EYE SURGERY (T2) # 1031 W WESTERN RESERVE RD POLAND, OH 44514 330 965-0900 LEE SURGERY CENTER (T2 .
