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CAH381314-03 SAMARITAN PACIFIC HEALTH SERVICES, INC., DBA SAMARITAN PACIFIC COMMUNITIES HOSPITAL (Active)
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Main Details
Name
SAMARITAN PACIFIC HEALTH SERVICES, INC., DBA SAMARITAN PACIFIC COMMUNITIES HOSPITAL
Subdivision Name
SPCH Depoe Bay Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381314-03
Medicare Provider Number
381314
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/3/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/31/2012
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Samaritan Health Services
Daniel Smith, VP Finance/CFO
(541) 768-5390
Primary Contact
Samaritan Lebanon Community Hospital
Daniel Rackham, Chief Executive Officer
(541) 451-7914
Addresses
Street Address
531 N Highway 101 Suite A
Depoe Bay, OR 97341
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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