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CAH501319-01 LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH (Active)
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Main Details
Name
LEWIS COUNTY HOSPITAL DISTRICT #1 DBA ARBOR HEALTH
Subdivision Name
RANDLE CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501319-01
Medicare Provider Number
501319
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/31/2016
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
A
Clint Scogin, Controller
(360) 496-3713
Primary Contact
Morton General Hospital
Shana Garcia, Executive Assistant
(360) 496-3537
Addresses
Street Address
108 KINDLE RD
RANDLE, WA 98377-9209
Billing Address
LEWIS COUNTY HOSPITAL DISTRICT #1 DBA MORTON GENERAL HOSPITAL
PO Box 1138
Morton, WA 98356
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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