Covered Entity Details

DSH500016A CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL (Active) - information as of 5/14/2025 10:55:29 PM

Main Details

Name

CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL

Subdivision Name

Infusion Services

Type

Disproportionate Share Hospital

Rural

340B ID

DSH500016A

Medicare Provider Number

500016

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/12/2013

Participating Start Date

7/1/2013

Participating Approval Date

5/15/2013

Last Recertification Date

8/15/2024

Contacts

Authorizing Official

Confluence Health
Kelly M Allen, CNO/Administrator
(509) 433-3133

Primary Contact

Confluence Health
Kristy Clare, 340B Pharmacy System Administrator
(509) 662-1511 Ext: 32149

Addresses

Street Address

820 N Chelan Avenue
Wenatchee, WA 98801

Billing Address

Confluence Health Hospital
PO Box 1885
Wenatchee, WA 98807

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
4/25/13-Ready for IS approval. Have all necessary documentation.	04/25/2013

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
WA	1007264,1043312	1306883228,1215970546

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH500016A	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Infusion Services	820 N Chelan Avenue	Wenatchee	WA	Active
DSH500016AA	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Mares Campus - Pre-Op/Phase II/Recovery - Pre-Op/Phase II/Recovery	820 North Chelan Avenue	Wenatchee	WA	Active
DSH500016AB	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Mares Campus - Emergency Services - Emergency Services	820 North Chelan Avenue	Wenatchee	WA	Active
DSH500016AC	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Haug Building - Dermatology/Skin Care - Dermatology/Skin Care	707 N. Emerson Ave	Wenatchee	WA	Active
DSH500016AD	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Mares Campus - Urology - Urology	820 North Chelan Avenue	Wenatchee	WA	Active
DSH500016AE	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Haug Building - Allergy - Allergy	707 N. Emerson Ave	Wenatchee	WA	Active
DSH500016AF	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Mares Campus - GI Surgery - GI Surgery	820 North Chelan Avenue	Wenatchee	WA	Active
DSH500016B	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Hospice	731 N. Chelan Ave	Wenatchee	WA	Active
DSH500016C	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Home Health	731 N. Chelan Ave	Wenatchee	WA	Active
DSH500016G	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Home Infusion	1201 S Miller Street	Wenatchee	WA	Active
DSH500016H	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Medical Oncology	820 North Chelan Avenue	Wenatchee	WA	Active
DSH500016J	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Medical Oncology-Moses Lake	840 East Hill Avenue	Moses Lake	WA	Active
DSH500016K	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Infusion Services-Moses Lake	840 East Hill Avenue	Moses Lake	WA	Active
DSH500016L	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Medical Oncology-Omak	916 Koala Drive	Omak	WA	Active
DSH500016M	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Infusion Services-Omak	916 Koala Drive	Omak	WA	Active
DSH500016N	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Saddle Rock Building - Rheumatology	1215 S. Miller St.	Wenatchee	WA	Active
DSH500016P	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Professional Building - Ophthalmology/Optometry	933 Red Apple Rd	Wenatchee	WA	Active
DSH500016Q	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Professional Building - Women's Health - Women's Health	933 Red Apple Rd	Wenatchee	WA	Active
DSH500016R	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Professional Building - OB/GYN - OB/GYN	933 Red Apple Rd	Wenatchee	WA	Active
DSH500016S	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Professional Building - Pulmonary	933 Red Apple Rd	WENATCHEE	WA	Active
DSH500016T	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Professional Building - Internal Medicine - Internal Medicine	933 Red Apple Rd	Wenatchee	WA	Active
DSH500016U	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Saddle Rock Building - Endocrinology - Endocrinology	1215 S. Miller St.	Wenatchee	WA	Active
DSH500016V	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Saddle Rock Building - Infectious Disease - Infectious Disease	1215 S. Miller St.	Wenatchee	WA	Active
DSH500016W	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Smith Building - Weight Management - Weight Management	803 N. Emerson Ave	Wenatchee	WA	Active
DSH500016X	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Smith Building - Pediatrics - Pediatrics	803 N. Emerson Ave	Wenatchee	WA	Active
DSH500016Y	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Mares Campus - Anticoagulation - Anticoagulation	820 North Chelan Avenue	Wenatchee	WA	Active
DSH500016Z	Child	DSH	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	Mares Campus - Surgery - Surgery/OR	820 North Chelan Avenue	Wenatchee	WA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	AO Change Request	Legel, Thomas CFO Confluence Health 5096621511	Allen, Kelly M CNO/Administrator Confluence Health 5094333133	1/3/2025 9:24 AM
Contacts	Primary Contact	Update	Profile Change Request	Clare, Kristy 340B Program Analyst Central Washington Hospital 5096621511-32149	Clare, Kristy 340B Pharmacy System Administrator Confluence Health 5096621511-32149	12/13/2024 2:20 PM
Addresses	Billing Address	Update	Recertification	Central Washington Hospital PO Box 1885 Wenatchee, WA 98807	Confluence Health Hospital PO Box 1885 Wenatchee, WA 98807	8/15/2024 4:46 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/15/2024 4:46 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1043312	8/15/2024 4:46 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		WA	8/15/2024 4:46 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1215970546	8/15/2024 4:46 PM
Medicaid Billing	NPI: State	Insert	Recertification		WA	8/15/2024 4:46 PM
Details	Last Recertification Date	Update	Recertification	8/30/2023 8:04:48 PM	8/15/2024 4:46:19 PM	8/15/2024 4:46 PM
Details	Entity Name	Update	Change Request	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CENTRAL WASHINGTON HOSPITAL	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL	9/21/2023 7:55 AM
Details	Last Recertification Date	Update	Recertification	9/13/2022 12:04:03 PM	8/30/2023 8:04:48 PM	8/30/2023 8:04 PM
Details	Last Recertification Date	Update	Recertification	8/17/2021 11:46:15 AM	9/13/2022 12:04:03 PM	9/13/2022 12:04 PM
Details	Last Recertification Date	Update	Recertification	8/24/2020 6:18:36 PM	8/17/2021 11:46:15 AM	8/17/2021 11:46 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1306883228	8/24/2020 6:18 PM
Medicaid Billing	NPI: State	Insert	Recertification		WA	8/24/2020 6:18 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1306883228 ( )		8/24/2020 6:18 PM
Details	Last Recertification Date	Update	Recertification	8/23/2019 12:44:01 PM	8/24/2020 6:18:36 PM	8/24/2020 6:18 PM
Contacts	Authorizing Official	Update	Change Request	Doyle, John CFO Central Washington Hospital 5094333809	Legel, Thomas CFO Confluence Health 5096621511	4/3/2020 4:39 PM
Contacts	Authorizing Official	Update	Change Request	Doyle, John CFO Central Washington Hospital 5094333809	Doyle, John CFO Central Washington Hospital 5094333809	11/14/2019 4:45 PM
Addresses	Billing Address	Insert	Change Request		Central Washington Hospital PO Box 1885 Wenatchee, WA 98807	11/11/2019 1:15 PM
Details	Last Recertification Date	Update	Recertification	8/28/2018 1:11:24 PM	8/23/2019 12:44:01 PM	8/23/2019 12:44 PM
Contacts	Primary Contact	Update	Change Request	Sieg, Michael Director of Pharmacy Central Washington Hospital 5094333556	Clare, Kristy 340B Program Analyst Central Washington Hospital 5096621511-32149	8/12/2019 12:36 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/12/2019 5:44 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1007264	7/12/2019 5:44 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WA	7/12/2019 5:44 PM
Addresses	Main Address	Update	Recertification	820 N Chelan Wenatchee, WA 98801	820 N Chelan Avenue Wenatchee, WA 98801	8/28/2018 1:11 PM
Details	Last Recertification Date	Update	Recertification	11/20/2017 5:09:22 PM	8/28/2018 1:11:24 PM	8/28/2018 1:11 PM
Contacts	Primary Contact	Update	Profile Change Request	Sieg, Michael Director of Pharmacy Central Washington Hospital 5096656021	Sieg, Michael Director of Pharmacy Central Washington Hospital 5094333556	8/27/2018 11:52 AM
Contacts	Authorizing Official	Update	Profile Change Request	Doyle, John CFO Central Washington Hospital 5096656015	Doyle, John CFO Central Washington Hospital 5094333809	8/27/2018 11:14 AM
Details	Last Recertification Date	Update	Recertification	8/22/2016 12:00:00 AM	11/20/2017 5:09:22 PM	11/20/2017 5:09 PM
Contacts	Authorizing Official	Update		Doyle, John CFO 5096656015	Doyle, John CFO Central Washington Hospital 5096656015	10/10/2017 2:01 PM
Contacts	Primary Contact	Update		Sieg, Michael Director of Pharmacy 5096656021	Sieg, Michael Director of Pharmacy Central Washington Hospital 5096656021	9/21/2017 9:20 AM
Contacts	Authorizing Official	Insert			Doyle, John CFO 5096656015	2/7/2017 9:05 AM
Contacts	Primary Contact	Update		Adams, Glenn Director of Pharmacy 5096656012	Sieg, Michael Director of Pharmacy 5096656021	2/7/2017 9:05 AM
Contacts	Signed By	Insert			JACOBS, STEVEN R. CFO 5096656014	2/7/2017 9:05 AM
Addresses	Main Address	Insert			820 N Chelan Wenatchee, WA 98801	1/20/2017 4:12 PM
Medicaid Billing	NPI: Number	Insert			1306883228	1/20/2017 4:12 PM
Details	Last Recertification Date	Update		8/19/2015 12:00:00 AM	8/22/2016 12:00:00 AM	8/22/2016 7:05 AM
Contacts	Primary Contact	Update		Adams, Glenn Director of Pharmacy 5096644868-5916	Adams, Glenn Director of Pharmacy 5096656012	8/22/2016 7:05 AM
Details	Last Recertification Date	Update		9/4/2014 12:00:00 AM	8/19/2015 12:00:00 AM	8/19/2015 9:33 AM
Contacts	Primary Contact	Insert			Adams, Glenn Director of Pharmacy 5096644868-5916	12/22/2014 9:14 AM
Details	Last Recertification Date	Update		9/5/2013 5:39:54 AM	9/4/2014 12:00:00 AM	9/4/2014 12:31 PM
Details	Last Recertification Date	Update			9/5/2013 5:39:54 AM	9/5/2013 5:39 AM
Details	340B ID	Update		ISDMDSH500016A	DSH500016A	5/15/2013 5:18 PM
Dates	Participating Approval Date	Update			5/15/2013 12:00:00 AM	5/15/2013 5:18 PM
Details	State	Update		Pending	Active	5/15/2013 5:18 PM
Dates	Start Date	Update			7/1/2013 12:00:00 AM	5/15/2013 5:18 PM
Details	Comments Public	Insert			4/25/13-Ready for IS approval. Have all necessary documentation.	4/25/2013 1:38 PM
Details	340B ID	Update		DM-041513K	ISDMDSH500016A	4/25/2013 1:35 PM
Details	340B ID	Update		DM041413D	DM-041513K	4/15/2013 12:04 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	DM041413D	4/14/2013 7:13 PM
Details	Last Recertification Date	Insert				4/12/2013 6:19 PM
Details	Grant Number	Insert				4/12/2013 6:19 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	4/12/2013 6:19 PM
Details	Is Authorizing Official EHB Data	Insert				4/12/2013 6:19 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/12/2013 6:19 PM
Details	Medicare Provider Number	Insert			500016	4/12/2013 6:19 PM
Details	Entity Name	Insert			CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CENTRAL WASHINGTON HOSPITAL	4/12/2013 6:19 PM
Details	Program Code	Insert			DSH	4/12/2013 6:19 PM
Details	Entity Subname	Insert			Infusion Services	4/12/2013 6:19 PM
Dates	Participating Approval Date	Insert				4/12/2013 6:19 PM
Details	State	Insert			Pending	4/12/2013 6:19 PM
Dates	Registration Date	Insert			4/12/2013 12:00:00 AM	4/12/2013 6:19 PM
Dates	Signed By Date	Insert			4/12/2013 12:00:00 AM	4/12/2013 6:19 PM
Dates	Start Date	Insert				4/12/2013 6:19 PM
Terminations	Termination Comments	Insert				4/12/2013 6:19 PM
Terminations	Termination Date	Insert				4/12/2013 6:19 PM
Terminations	Termination Effective Date	Insert				4/12/2013 6:19 PM
Terminations	Termination Reason	Insert				4/12/2013 6:19 PM