Provider Demographics
NPI:1750261392
Name:SANTIAM MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:SANTIAM MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF REVENUE AND R
Authorized Official - Prefix:
Authorized Official - First Name:CASSONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:POSVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-769-9255
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:STAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97383-0577
Mailing Address - Country:US
Mailing Address - Phone:503-769-9255
Mailing Address - Fax:503-769-3472
Practice Address - Street 1:280 S 1ST AVE STE A
Practice Address - Street 2:
Practice Address - City:MILL CITY
Practice Address - State:OR
Practice Address - Zip Code:97360-1404
Practice Address - Country:US
Practice Address - Phone:503-769-9255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANTIAM MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy