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CAH381306-01 Wallowa County Health Care District DBA Wallowa Memorial Hospital (Active)
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Main Details
Name
Wallowa County Health Care District DBA Wallowa Memorial Hospital
Subdivision Name
Wallowa Memorial Medical Clinic - Enterprise
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381306-01
Medicare Provider Number
381306
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/29/2015
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Wallowa County Health Care District
Nathan Hiebert, CFO
(541) 426-5460
Primary Contact
Wallowa County Health Care District dba Wallowa Memorial Hospital
Jenni Word, CNO
(541) 426-5305
Addresses
Street Address
603 Medical Parkway
Enterprise, OR 97828
Billing Address
Wallowa Memorial Medical Clinic - Enterprise
601 Medical Parkway
Enterprise, OR 97828
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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