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CAH381323-25 MID-VALLEY HEALTHCARE, INC. DBA SAMARITAN LEBANON COMMUNITY HOSPITAL (Active)
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Main Details
Name
MID-VALLEY HEALTHCARE, INC. DBA SAMARITAN LEBANON COMMUNITY HOSPITAL
Subdivision Name
LCH SH Urgent Care WI RHC - LCH - Urgent Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381323-25
Medicare Provider Number
381323
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/18/2024
Last Recertification Date
Contacts
Authorizing Official
Samaritan Health Services
Daniel Smith, VP Finance/CFO
(541) 768-5390
Primary Contact
Samaritan Lebanon Community Hospital
Daniel Rackham, Chief Executive Officer
(541) 451-7914
Addresses
Street Address
1289 49th Avenue
Sweet Home, OR 97386
Billing Address
Samaritan Health Services, Inc.
PO Box 3000
Corvallis, OR 97339
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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