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DSH380022M SAMARITAN ALBANY GENERAL HOSPITAL (Terminated)
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Main Details
Name
SAMARITAN ALBANY GENERAL HOSPITAL
Subdivision Name
Ambulatory Infusion - Neville
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380022M
Medicare Provider Number
380022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2013
Participating Start Date
7/1/2013
Participating Approval Date
6/18/2013
Last Recertification Date
8/31/2015
Termination Date
Termination Reason
4/1/2016
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
3615 NW Samaritan Drive Suite G-12
Corvallis, OR 97330
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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