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DSH380052 SAINT ALPHONSUS MEDICAL CENTER - ONTARIO INC. (Terminated)
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Main Details
Name
SAINT ALPHONSUS MEDICAL CENTER - ONTARIO INC.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380052
Medicare Provider Number
380052
Additional Details
Current Program Status
Terminated
Registration Date
4/28/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/28/2008
Last Recertification Date
8/30/2018
Termination Date
Termination Reason
4/1/2019
Change of covered entity type
Contacts
Authorizing Official
Saint Alphonsus Health System
Lannie Checketts, RHM CFO Idaho Oregon Region
(208) 367-7347
Primary Contact
Trinity Health
Carisa Ann McGehee, 340B Analyst
(208) 367-2087
Addresses
Street Address
351 SW 9TH STREET
ONTARIO, OR 97914
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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02/17/11 UPDATED ENTITY NAME(WAS HOLY ROSARY MEDICAL CENTER)
02/17/2011
May 2025
May 2025
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