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DSH380029 SILVERTON HEALTH DBA LEGACY SILVERTON MEDICAL CENTER OR SILVERTON HEALTH (Active)
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Main Details
Name
SILVERTON HEALTH DBA LEGACY SILVERTON MEDICAL CENTER OR SILVERTON HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380029
Medicare Provider Number
380029
Additional Details
Current Program Status
Active
Registration Date
10/13/2018
Participating Start Date
1/1/2019
Participating Approval Date
11/19/2018
Last Recertification Date
9/2/2024
Contacts
Authorizing Official
Legacy Health
Kecia Kelly, SVP Chief Nursing Officer
(503) 415-5199
Primary Contact
Legacy Health
Elena Valcarlos, Pharmacy Systems Manager
(503) 413-7764
Addresses
Street Address
342 FAIRVIEW STREET
SILVERTON, OR 97381-1993
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2006, terminated 10/1/2016. Reinstated 1/1/2019.
11/14/2018
2/23/12 UPDATED ENTITY NAME (WAS SILVERTON HOSPITAL), ADDED SHIP ADD1
02/23/2012
April 2025
April 2025
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