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CAH381320-13 Columbia Lutheran Charities DBA Columbia Memorial Hospital (Active)
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Main Details
Name
Columbia Lutheran Charities DBA Columbia Memorial Hospital
Subdivision Name
COLUMBIA LUTHERAN CHARITIES - Seaside Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381320-13
Medicare Provider Number
381320
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/19/2021
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
1111 N ROOSEVELT DR
STE 210
SEASIDE, OR 97138-4604
Billing Address
Columbian Lutheran Charities DBA Columbia Memorial Hospital
CMH Seaside Primary Care Clinic
2111 Exchange Street
Astoria, OR 97103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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