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CAH381312-00 COQUILLE VALLEY HOSPITAL DISTRICT (Active)
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Main Details
Name
COQUILLE VALLEY HOSPITAL DISTRICT
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH381312-00
Medicare Provider Number
381312
Additional Details
Current Program Status
Active
Registration Date
1/2/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/10/2018
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Coquille Valley Hospital
Jeffrey M. Lang, CEO
(541) 396-1052
Primary Contact
Coquille Valley Hospital
Beth Heatongrindel, Executive Assistant
(541) 396-3101 Ext: 1052
Addresses
Street Address
940 E. 5th Street
COQUILLE, OR 97423
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Started 1/1/2011; Terminated 1/1/2018; reinstated 4/1/2018.
01/08/2018
April 2025
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