340B Drug Pricing Program Database

Name

ASANTE ROGUE REGIONAL MEDICAL CENTER

Subdivision Name

RVMC CARDIOVASCULAR LAB / CVI Cath Lab

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH380018A

Medicare Provider Number

380018

Outpatient Facility Provider Number

Current Program Status

Terminated

Registration Date

10/11/2016

Participating Start Date

1/1/2017

Participating Approval Date

10/19/2016

Last Recertification Date

Termination Date
Termination Reason

1/1/2018
Business decision by the Covered Entity

Authorizing Official

Asante
Greg Wojtal, Chief Administrative and Finance Officer
(541) 789-4549

Primary Contact

Asante
Amy Watson, Director of Pharmacy
(541) 789-5031

Street Address

520 MEDICAL CENTER DRIVE
MEDFORD, OR 97504-4334

Billing Address
Same as Street Address