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DSH500033 SAMARITAN HOSPITAL (Terminated)
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Main Details
Name
SAMARITAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500033
Medicare Provider Number
500033
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2008
Participating Start Date
1/1/2009
Participating Approval Date
12/3/2008
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
7/1/2020
Change of covered entity type
Contacts
Authorizing Official
Samaritan Healthcare
Alexander Town, Chief Financial Officer
(509) 793-9710
Primary Contact
Samaritan Healthcare
Lloyd Stever, Director of Pharmacy
(509) 793-9677
Addresses
Street Address
801 E WHEELER ROAD
MOSES LAKE, WA 98837
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
April 2025
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