Covered Entity Details

CAH501319-05 LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH (Active) - information as of 6/6/2025 3:40:46 AM

Main Details

Name

LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH

Subdivision Name

RAPID CARE CLINIC - Walk in clinic

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH501319-05

Medicare Provider Number

501319

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/10/2023

Participating Start Date

1/1/2024

Participating Approval Date

10/17/2023

Last Recertification Date

8/29/2024

Contacts

Authorizing Official

A
Clint Scogin, Controller
(360) 496-3713

Primary Contact

A
Clint Scogin, Controller
(360) 496-3713

Addresses

Street Address

521 Adams Ave
Morton, WA 98356

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
CAH501319-01	Child	CAH	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	RANDLE CLINIC	108 KINDLE RD	RANDLE	WA	Active
CAH501319-02	Child	CAH	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	MOSSYROCK CLINIC	745 WILLIAMS ST	MOSSYROCK	WA	Active
CAH501319-03	Child	CAH	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	Womens Clinic	521 Adams Avenue	Morton	WA	Active
CAH501319-04	Child	CAH	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	SPECIALTY CLINIC	521 ADAMS AVE	MORTON	WA	Active
CAH501319-05	Child	CAH	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	RAPID CARE CLINIC - Walk in clinic	521 Adams Ave	Morton	WA	Active
CAH501319-06	Child	CAH	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	MORTON CLINIC - Family practice	521 Adams Ave	Morton	WA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	AO Change Request	Cornwell, Cheryl J CFO Arbor Health 3604963647	Scogin, Clint Controller A 3604963713	4/21/2025 2:09 PM
Details	Last Recertification Date	Update	Recertification		8/29/2024 12:42:07 PM	8/29/2024 12:42 PM
Details	State	Update		Approved	Active	1/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Cornwell, Cheryl J CFO Arbor Health 3604963647	10/17/2023 1:59 PM
Details	340B ID	Update	New Registration		CAH501319-05	10/17/2023 1:59 PM
Details	Entity Name	Update	New Registration	ARBOR HEALTH MORTON HOSPITAL	LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH	10/17/2023 1:59 PM
Details	Entity Subname	Update	New Registration	RAPID CARE CLINIC	RAPID CARE CLINIC - Walk in clinic	10/17/2023 1:59 PM
Dates	Participating Approval Date	Update	New Registration		10/17/2023 1:59:23 PM	10/17/2023 1:59 PM
Details	State	Update	New Registration	Pending	Approved	10/17/2023 1:59 PM
Dates	Signed By Date	Update	New Registration		10/16/2023 3:06:41 PM	10/17/2023 1:59 PM
Dates	Start Date	Update	New Registration		1/1/2024 12:00:00 AM	10/17/2023 1:59 PM
Addresses	Main Address	Insert	New Registration		521 Adams Ave Morton, WA 98356	10/10/2023 4:33 PM
Contacts	Authorizing Official	Insert	New Registration		Cornwell, Cheryl J CFO Arbor Health 3604963647	10/10/2023 4:33 PM
Contacts	Primary Contact	Insert	New Registration		Scogin, Clint Controller A 3604963713	10/10/2023 4:33 PM
Details	Assistance Received From Date	Insert	New Registration			10/10/2023 4:33 PM
Details	Assistance Received To Date	Insert	New Registration			10/10/2023 4:33 PM
Details	Last Recertification Date	Insert	New Registration			10/10/2023 4:33 PM
Details	Grant Number	Insert	New Registration			10/10/2023 4:33 PM
Details	340B ID	Insert	New Registration			10/10/2023 4:33 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/10/2023 4:33 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/10/2023 4:33 PM
Details	Medicare Provider Number	Insert	New Registration		501319	10/10/2023 4:33 PM
Details	Entity Name	Insert	New Registration		ARBOR HEALTH MORTON HOSPITAL	10/10/2023 4:33 PM
Details	NOFO Number	Insert	New Registration			10/10/2023 4:33 PM
Details	Program Code	Insert	New Registration		CAH	10/10/2023 4:33 PM
Details	Entity Subname	Insert	New Registration		RAPID CARE CLINIC	10/10/2023 4:33 PM
Dates	Participating Approval Date	Insert	New Registration			10/10/2023 4:33 PM
Details	State	Insert	New Registration		Pending	10/10/2023 4:33 PM
Dates	Registration Date	Insert	New Registration		10/10/2023 4:33:11 PM	10/10/2023 4:33 PM
Dates	Signed By Date	Insert	New Registration			10/10/2023 4:33 PM
Dates	Start Date	Insert	New Registration			10/10/2023 4:33 PM
Terminations	Termination Comments	Insert	New Registration			10/10/2023 4:33 PM
Terminations	Termination Date	Insert	New Registration			10/10/2023 4:33 PM
Terminations	Termination Effective Date	Insert	New Registration			10/10/2023 4:33 PM
Terminations	Termination Reason	Insert	New Registration			10/10/2023 4:33 PM