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RRC380014-17 GOOD SAMARITAN HOSPITAL CORVALLIS (Active)
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Main Details
Name
GOOD SAMARITAN HOSPITAL CORVALLIS
Subdivision Name
GOOD SAMARITAN HOSPITAL CORVALLIS - GSR Infectious Disease
Type
Rural Referral Center
Rural
Yes
340B ID
RRC380014-17
Medicare Provider Number
380014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/13/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/22/2018
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Samaritan Health Services
Daniel Smith, VP Finance/CFO
(541) 768-5390
Primary Contact
Samaritan Lebanon Community Hospital
Daniel Rackham, Chief Executive Officer
(541) 451-7914
Addresses
Street Address
3640 NW SAMARITAN DR Suite 210
CORVALLIS, OR 97330-3787
Billing Address
Samaritan Health Services, Inc.
PO BOX 3000
Corvallis, OR 97339
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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