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CAH381317-00 NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK D/B/A TILLAMOOK REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK D/B/A TILLAMOOK REGIONAL MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381317-00
Medicare Provider Number
381317
Additional Details
Current Program Status
Active
Registration Date
8/17/2010
Participating Start Date
9/30/2010
Participating Approval Date
9/30/2010
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Adventist Health Tillamook
Heather Thompson, Patient Care Executive
(503) 815-2258
Primary Contact
Tillamook Regional Medical Center
KYLE CONNAUGHTON, PHARMACY DIRECTOR
(503) 815-2260
Addresses
Street Address
1000 3RD STREET
TILLAMOOK, OR 97141
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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