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CAH501304-03 Grays Harbor County Public Hospital District No. 1 DBA Summit Pacific Medical Center (Active)
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Main Details
Name
Grays Harbor County Public Hospital District No. 1 DBA Summit Pacific Medical Center
Subdivision Name
McCleary Healthcare Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501304-03
Medicare Provider Number
501304
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/11/2014
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Grays Harbor County Public Hospital District No 1
Josh Martin, CEO
(360) 346-2244
Primary Contact
Summit Pacific Medical Center
Andrew Joseph Burton, Pharmacy Director
(360) 346-2238
Addresses
Street Address
105 W. Simpson Ave.
MCCLEARY, WA 98557
Billing Address
Summit Pacific Medical Center
600 East Main St
Elma, WA 98541
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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