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SCH380001-06 Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge (Active)
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Main Details
Name
Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge
Subdivision Name
MCMC PEDIATRICS - RURAL HEALTH CLINIC
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH380001-06
Medicare Provider Number
380001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/7/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/18/2012
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Adventist Health Columbia Gorge
Jayme Beth Thompson, Administrator
(541) 506-6941
Primary Contact
Adventist Health Columbia Gorge
Amanda Dawn Cummings, PharmD, Director of Pharmacy
(541) 296-7526
Addresses
Street Address
1935 East 19th Street
The Dalles, OR 97058
Billing Address
Mid-Columbia Medical Center
P.O. Box 1520
The Dalles, OR 97058
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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