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CAH381314-01 SAMARITAN PACIFIC HEALTH SERVICES, INC., DBA SAMARITAN PACIFIC COMMUNITIES HOSPITAL (Terminated)
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Main Details
Name
SAMARITAN PACIFIC HEALTH SERVICES, INC., DBA SAMARITAN PACIFIC COMMUNITIES HOSPITAL
Subdivision Name
PCH WALK-IN CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381314-01
Medicare Provider Number
381314
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/3/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/31/2012
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
7/1/2021
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Samaritan Health Services
Daniel Smith, VP Finance/CFO
(541) 768-5390
Primary Contact
Samaritan Health Services
Joy R Douglas, Rx data Coordinator - 340B Contract Pharmacy
(541) 768-6867
Addresses
Street Address
930 SW Abbey Street Suite F
Newport, OR 97365
Billing Address
Samaritan Health Services, Inc.
PO BOX 3000
Corvallis, OR 97339
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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