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CAH381309-00 LAKE DISTRICT HOSPITAL (Active)
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Main Details
Name
LAKE DISTRICT HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH381309-00
Medicare Provider Number
381309
Additional Details
Current Program Status
Active
Registration Date
9/27/2010
Participating Start Date
9/28/2010
Participating Approval Date
9/28/2010
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Lake District Hospital
Landon M Dybdal, Chief Executive Officer
(541) 947-2114 Ext: 221
Primary Contact
Lake District Hospital
TERESA DECKER, DIRECTOR OF PHARMACY
(541) 947-2114 Ext: 281
Addresses
Street Address
700 SOUTH J ST.
LAKEVIEW, OR 97630
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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