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CAH381314-19 SAMARITAN PACIFIC HEALTH SERVICES, INC., DBA SAMARITAN PACIFIC COMMUNITIES HOSPITAL (Active)
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Main Details
Name
SAMARITAN PACIFIC HEALTH SERVICES, INC., DBA SAMARITAN PACIFIC COMMUNITIES HOSPITAL
Subdivision Name
PCH Diabetes Management - PCH Diabetes Management
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH381314-19
Medicare Provider Number
381314
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/3/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/18/2024
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
930 SW Abbey Street
Newport, OR 97365
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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