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CAH381323-21 MID-VALLEY HEALTHCARE, INC. DBA SAMARITAN LEBANON COMMUNITY HOSPITAL (Active)
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Main Details
Name
MID-VALLEY HEALTHCARE, INC. DBA SAMARITAN LEBANON COMMUNITY HOSPITAL
Subdivision Name
LCH Samaritan Fam Med SLHC - LCH Samaritan Fam Med SLHC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381323-21
Medicare Provider Number
381323
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/12/2022
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
675 North 5th St Suite 200
Lebanon, OR 97355
Billing Address
Samaritan Health Services
PO Box 3000
Corvallis, OR 97339
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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