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CAH381320-12 Columbia Lutheran Charities DBA Columbia Memorial Hospital (Active)
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Main Details
Name
Columbia Lutheran Charities DBA Columbia Memorial Hospital
Subdivision Name
Astoria Primary Care - Primary Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381320-12
Medicare Provider Number
381320
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/22/2019
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Columbia Memorial Hospital
Chris Laman, Vice President of Strategy
(503) 338-7505
Primary Contact
Columbia Memorial Hospital
Jeffrey Chow, Outpatient Pharmacy Manager
(503) 738-3006
Addresses
Street Address
2158 Exchange ST
STE 107
Astoria, OR 97103
Billing Address
Columbian Lutheran Charities DBA Columbia Memorial Hospital
CMH Astoria Primary Care Clinic
2111 Exchange Street
Astoria, OR 97103
Comments
Medicaid Billing
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