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DSH380022J SAMARITAN ALBANY GENERAL HOSPITAL (Terminated)
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Main Details
Name
SAMARITAN ALBANY GENERAL HOSPITAL
Subdivision Name
SAGH North Albany Cardiology Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380022J
Medicare Provider Number
380022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/3/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
Last Recertification Date
8/29/2016
Termination Date
Termination Reason
1/1/2017
Site closure
Contacts
Authorizing Official
Samaritan Albany General Hospital
DANIEL B. SMITH, VP FINANCE/CFO
(541) 768-5390
Primary Contact
Good Samaritan Regional Medical Center
Penny Reher, Chief Pharmacy Officer
(541) 768-6177
Addresses
Street Address
400 NW Hickory Street Suite 300
Albany, OR 97321
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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