340B Drug Pricing Program Database
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CAH501326-00 Providence Mount Carmel Hospital (Active)
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Main Details
Name
Providence Mount Carmel Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501326-00
Medicare Provider Number
501326
Additional Details
Current Program Status
Active
Registration Date
8/21/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/10/2012
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Providence Mt. Carmel Hospital
Ron Anthony Lawrence, Regional Director Finance Operations
(509) 474-3208
Primary Contact
Providence Health & Services - WA
Michelle Sodorff, Director, Pharmacy
(509) 474-3232
Addresses
Street Address
982 E Columbia Ave
Colville, WA 99114
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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