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CAH381304-00 SOUTHERN COOS GENERAL HOSPITAL (Active)
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Main Details
Name
SOUTHERN COOS GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381304-00
Medicare Provider Number
381304
Additional Details
Current Program Status
Active
Registration Date
7/14/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/25/2015
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Southern Coos Hospital
Raymond T Hino, CEO
(541) 347-2426 Ext: 114
Primary Contact
Southern Coos Hospital & Health Center
Jeffery Turner, Pharmacy RN
(541) 347-2426 Ext: 137
Addresses
Street Address
900 11TH STREET SE
BANDON, OR 97411
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/25/15 Participated starting 1/1/2011, terminated 10/1/2013 due to failure to recertify, Reinstated based on new registration in July 2015
08/25/2015
May 2025
May 2025
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