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DSH380050 Sky Lakes Medical Center (Active)
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Main Details
Name
Sky Lakes Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380050
Medicare Provider Number
380050
Additional Details
Current Program Status
Active
Registration Date
5/21/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/14/2012
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Sky Lakes Medical Center
Richard E. Rico, Vice President/CFO
(541) 274-6150
Primary Contact
Sky Lakes Medical Center
Mychal Amos, Director of Pharmacy Services
(541) 274-3799
Addresses
Street Address
2865 Daggett Avenue
Klamath Falls, OR 97601
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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