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RRC500072-00 OLYMPIC MEDICAL CENTER (Active)
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Main Details
Name
OLYMPIC MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC500072-00
Medicare Provider Number
500072
Additional Details
Current Program Status
Active
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/22/2015
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Clallam County Pub Hosp Dist #2 dba Olympic Medical Center
Darryl Wolfe, Chief Executive Officer
(360) 417-7705
Primary Contact
Olympic Medical Center
Karen Bright, Director of Pharmacy
(360) 417-7168
Addresses
Street Address
939 CAROLINE STREET
PORT ANGELES, WA 98362
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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