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DSH380022 SAMARITAN ALBANY GENERAL HOSPITAL (Active)
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Main Details
Name
SAMARITAN ALBANY GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380022
Medicare Provider Number
380022
Additional Details
Current Program Status
Active
Registration Date
11/30/2007
Participating Start Date
4/1/2012
Participating Approval Date
3/30/2012
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Samaritan Albany General Hospital
DANIEL B. SMITH, VP FINANCE/CFO
(541) 768-5390
Primary Contact
Samaritan Lebanon Community Hospital
Daniel Rackham, Chief Executive Officer
(541) 451-7914
Addresses
Street Address
1046 6TH AVE SW
ALBANY, OR 97321
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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3/30/12 participating 1/1/08 thru 6/30/10, not participating 7/1/10 thru 3/31/12, added NPI #; 10/5/09- DOC RECD TO CONFIRM ELIG DSH ADJ %
03/30/2012
6/4/2010- TERMINATION DUE TO FALLING BELOW DSH 10/5/09- DOC RECD TO CONFIRM ELIG DSH ADJ %
06/30/2010
April 2025
April 2025
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