Covered Entity Details

CAH501331-08 Public Hospital District #1-A DBA Pullman Regional Hospital (Approved) - information as of 6/28/2025 12:24:30 AM

Main Details

Name

Public Hospital District #1-A DBA Pullman Regional Hospital

Subdivision Name

Palouse Medical - Internal Medicine

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH501331-08

Medicare Provider Number

501331

Outpatient Facility Provider Number

Additional Details

Current Program Status

Approved

Registration Date

4/11/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/30/2025

Last Recertification Date

Contacts

Authorizing Official

Pullman Regional Hospital
Steve Douglas Febus, CFO
(509) 336-7362

Primary Contact

Pullman Regional Hospital
Andrea Lee Howell, Director of Pharmacy
(509) 336-7545

Addresses

Street Address

825 SE Bishop Blvd
200
Pullman, WA 99163

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH501331-01	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Family Medicine Residency Center - Family Medicine	825 SE Bishop Blvd	Pullman	WA	Active
CAH501331-02	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Palouse Heart Center - Non-invasive cardiology	825 SE Bishop Blvd.	Pullman	WA	Active
CAH501331-03	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Palouse Psychiatry & Behavioral Health - Behavioral Health	825 SE Bishop Blvd	Pullman	WA	Active
CAH501331-04	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Palouse Sleep Medicine - Sleep Medicine	825 SE Bishop Blvd	Pullman	WA	Active
CAH501331-05	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Palouse Urology Center - Urology	825 SE Bishop Blvd	Pullman	WA	Active
CAH501331-06	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Pullman Foot & Ankle - Foot & Ankle	825 SE Bishop Blvd	Pullman	WA	Active
CAH501331-07	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Pullman Surgical Associates - General Surgery	825 SE Bishop Blvd	Pullman	WA	Active
CAH501331-08	Child	CAH	Public Hospital District #1-A DBA Pullman Regional Hospital	Palouse Medical - Internal Medicine	825 SE Bishop Blvd	Pullman	WA	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Febus, Steve Douglas CFO Pullman Regional Hospital 5093367362	4/30/2025 9:25 AM
Details	340B ID	Update	New Registration		CAH501331-08	4/30/2025 9:25 AM
Details	Entity Name	Update	New Registration	PULLMAN REGIONAL HOSPITAL	Public Hospital District #1-A DBA Pullman Regional Hospital	4/30/2025 9:25 AM
Details	Entity Subname	Update	New Registration	Palouse Medical	Palouse Medical - Internal Medicine	4/30/2025 9:25 AM
Dates	Participating Approval Date	Update	New Registration		4/30/2025 9:25:25 AM	4/30/2025 9:25 AM
Details	State	Update	New Registration	Pending	Approved	4/30/2025 9:25 AM
Dates	Signed By Date	Update	New Registration		4/28/2025 10:54:50 AM	4/30/2025 9:25 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/30/2025 9:25 AM
Addresses	Main Address	Insert	New Registration		825 SE Bishop Blvd 200 Pullman, WA 99163	4/11/2025 5:59 PM
Contacts	Primary Contact	Insert	New Registration		Howell, Andrea Lee Director of Pharmacy Pullman Regional Hospital 5093367545	4/11/2025 5:59 PM
Contacts	Authorizing Official	Insert	New Registration		Febus, Steve Douglas CFO Pullman Regional Hospital 5093367362	4/11/2025 5:59 PM
Details	Assistance Received From Date	Insert	New Registration			4/11/2025 5:59 PM
Details	Assistance Received To Date	Insert	New Registration			4/11/2025 5:59 PM
Details	Last Recertification Date	Insert	New Registration			4/11/2025 5:59 PM
Details	Grant Number	Insert	New Registration			4/11/2025 5:59 PM
Details	340B ID	Insert	New Registration			4/11/2025 5:59 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/11/2025 5:59 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/11/2025 5:59 PM
Details	Medicare Provider Number	Insert	New Registration		501331	4/11/2025 5:59 PM
Details	Entity Name	Insert	New Registration		PULLMAN REGIONAL HOSPITAL	4/11/2025 5:59 PM
Details	NOFO Number	Insert	New Registration			4/11/2025 5:59 PM
Details	Program Code	Insert	New Registration		CAH	4/11/2025 5:59 PM
Details	Entity Subname	Insert	New Registration		Palouse Medical	4/11/2025 5:59 PM
Dates	Participating Approval Date	Insert	New Registration			4/11/2025 5:59 PM
Details	State	Insert	New Registration		Pending	4/11/2025 5:59 PM
Dates	Registration Date	Insert	New Registration		4/11/2025 5:59:27 PM	4/11/2025 5:59 PM
Dates	Signed By Date	Insert	New Registration			4/11/2025 5:59 PM
Dates	Start Date	Insert	New Registration			4/11/2025 5:59 PM
Terminations	Termination Comments	Insert	New Registration			4/11/2025 5:59 PM
Terminations	Termination Date	Insert	New Registration			4/11/2025 5:59 PM
Terminations	Termination Effective Date	Insert	New Registration			4/11/2025 5:59 PM
Terminations	Termination Reason	Insert	New Registration			4/11/2025 5:59 PM