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CAH381318-00 PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL (Active)
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Main Details
Name
PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381318-00
Medicare Provider Number
381318
Additional Details
Current Program Status
Active
Registration Date
10/1/2010
Participating Start Date
4/1/2011
Participating Approval Date
2/25/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Providence Hood River Memorial Hospital
Jeanette Carol Vieira, CEO
(541) 387-6456
Primary Contact
Providence Health and Services
Mac Ovenell, 340B Director
(509) 860-8643
Addresses
Street Address
810 12th Street
HOOD RIVER, OR 97031-1587
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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