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CAH501303-00 WILLAPA HARBOR HOSPITAL (Active)
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Main Details
Name
WILLAPA HARBOR HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501303-00
Medicare Provider Number
501303
Additional Details
Current Program Status
Active
Registration Date
7/6/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/12/2017
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Willapa Harbor Hospital
Matthew Brian Kempton, CEO
(360) 875-4528
Primary Contact
Willapa Harbor Hospital
STACEY L SCHMIDT, Director of Pharmacy
(360) 875-4539
Addresses
Street Address
800 ALDER STREET
SOUTH BEND, WA 98586
Billing Address
Willapa Harbor Hospital
PO Box 438
South Bend, WA 98586-0438
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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