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CAH501312-06 PROSSER MEMORIAL HOSPITAL (Active)
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Main Details
Name
PROSSER MEMORIAL HOSPITAL
Subdivision Name
PROSSER PUBLIC HOSPITAL DISTRICT OF - Prosser Rural Health Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501312-06
Medicare Provider Number
501312
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/4/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/8/2024
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Prosser Memorial Health
David Eugene Rollins, Chief Financial Officer
(509) 786-6605 Ext: 5097866605
Primary Contact
Prosser Memorial Health
Abigail Roy, Senior Staff Accountant
(509) 786-5531
Addresses
Street Address
336 CHARDONNAY AVE
STE A
PROSSER, WA 99350-9515
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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