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CAH131308-00 CASCADE MEDICAL CENTER (Active)
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Main Details
Name
CASCADE MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH131308-00
Medicare Provider Number
131308
Additional Details
Current Program Status
Active
Registration Date
1/3/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/8/2018
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Cascade Medical Center Hospital District
Tom Reinhardt, CEO
(208) 408-5030
Primary Contact
Cascade Medical Center
Randy Kyrias, CFO
(208) 408-5062
Addresses
Street Address
402 Lake Cascade Parkway
CASCADE, ID 83611-0151
Billing Address
CASCADE MEDICAL CENTER
P.O. Box 1330
402 Lake Cascade Parkway
CASCADE, ID 83611
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Initial start 10/1/2014, Termination 1/1/2018, Reinstate 4/1/2018.
01/04/2018
April 2025
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