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CAH501312-00 PROSSER MEMORIAL HOSPITAL (Active)
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Main Details
Name
PROSSER MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501312-00
Medicare Provider Number
501312
Additional Details
Current Program Status
Active
Registration Date
1/4/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/22/2019
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Prosser Memorial Health
David Eugene Rollins, Chief Financial Officer
(509) 786-6605 Ext: 5097866605
Primary Contact
Prosser Memorial Health
Kassidy Ferguson, Senior Staff Accountant
(509) 786-5540
Addresses
Street Address
200 Prosser Health Drive
PROSSER, WA 99350
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2011; Terminated 10/1/2018; Reinstated 4/1/2019.
01/14/2019
April 2025
April 2025
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