340B Drug Pricing Program Database
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SCH500033-01 SAMARITAN HOSPITAL (Terminated)
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Main Details
Name
SAMARITAN HOSPITAL
Subdivision Name
SAMARITAN HOSPITAL - Primary Care
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH500033-01
Medicare Provider Number
500033
Outpatient Facility Provider Number
508536
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/22/2020
Last Recertification Date
8/25/2020
Termination Date
Termination Reason
7/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Samaritan Healthcare
Alexander Town, Chief Financial Officer
(509) 793-9710
Primary Contact
Samaritan Healthcare
Loyd Stever, Pharmacy Director
(509) 793-9675
Addresses
Street Address
1550 S PIONEER WAY
MOSES LAKE, WA 98837-4613
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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