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CAH381302-00 SAMARITAN NORTH LINCOLN HOSPITAL (Active)
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Main Details
Name
SAMARITAN NORTH LINCOLN HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381302-00
Medicare Provider Number
381302
Additional Details
Current Program Status
Active
Registration Date
8/2/2010
Participating Start Date
8/3/2010
Participating Approval Date
8/3/2010
Last Recertification Date
8/23/2024
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
3043 NE 28TH ST.
LINCOLN CITY, OR 97367
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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08/10/11 added ship to addr. 03/08/11 REMOVED NPI#(1306897491)
08/10/2011
03/08/11 REMOVED NPI#(1306897491)
03/08/2011
April 2025
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