Covered Entity Details

DSH500016R CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL (Active) - information as of 5/20/2025 11:47:00 PM

Main Details

Name

CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL

Subdivision Name

Professional Building - OB/GYN - OB/GYN

Type

Disproportionate Share Hospital

Rural

340B ID

DSH500016R

Medicare Provider Number

500016

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/2/2019

Participating Start Date

10/1/2019

Participating Approval Date

8/7/2019

Last Recertification Date

8/16/2024

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

933 Red Apple Rd
Wenatchee, WA 98801

Billing Address

Confluence Health
PO Box 1885
Wenatchee, WA 98807

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

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	1007264,1021258,1043312	1306883228,1881642239,1215970546

Shipping Addresses

Shipping Address 1

Confluence Health Hospital
1201 S. Miller Street
Wenatchee, WA 98801

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	Insert	Change Request		Confluence Health PO Box 1885 Wenatchee, WA 98807	10/9/2024 12:04 PM
Addresses	Shipping Address	Delete	Recertification	Central Washington Hospital 1201 S. Miller Street Wenatchee, WA 98801		8/16/2024 7:46 AM
Addresses	Shipping Address	Insert	Recertification		Confluence Health Hospital 1201 S. Miller Street Wenatchee, WA 98801	8/16/2024 7:46 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/16/2024 7:46 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1043312	8/16/2024 7:46 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		WA	8/16/2024 7:46 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1215970546	8/16/2024 7:46 AM
Medicaid Billing	NPI: State	Insert	Recertification		WA	8/16/2024 7:46 AM
Details	Last Recertification Date	Update	Recertification	8/30/2023 8:03:18 PM	8/16/2024 7:46:24 AM	8/16/2024 7:46 AM
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 12:10:28 PM	8/30/2023 8:03:18 PM	8/30/2023 8:03 PM
Details	Last Recertification Date	Update	Recertification	8/17/2021 11:47:26 AM	9/13/2022 12:10:28 PM	9/13/2022 12:10 PM
Details	Last Recertification Date	Update	Recertification	8/24/2020 6:23:40 PM	8/17/2021 11:47:26 AM	8/17/2021 11:47 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1306883228 ( )		8/24/2020 6:23 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1881642239 ( )		8/24/2020 6:23 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1306883228	8/24/2020 6:23 PM
Medicaid Billing	NPI: State	Insert	Recertification		WA	8/24/2020 6:23 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1881642239	8/24/2020 6:23 PM
Medicaid Billing	NPI: State	Insert	Recertification		WA	8/24/2020 6:23 PM
Details	Last Recertification Date	Update	Recertification		8/24/2020 6:23:40 PM	8/24/2020 6:23 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
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	11/11/2019 1:08 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1021258	11/11/2019 1:08 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WA	11/11/2019 1:08 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1881642239	11/11/2019 1:08 PM
Details	State	Update		Approved	Active	10/1/2019 12:04 AM
Addresses	Shipping Address	Insert	Change Request		Central Washington Hospital 1201 S. Miller Street Wenatchee, WA 98801	8/27/2019 7:13 AM
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 3:22 PM
Medicaid Billing	Medicaid: Number	Update	Change Request	1021258	1007264	8/8/2019 2:20 PM
Medicaid Billing	NPI: Number	Update	Change Request	1881642239	1306883228	8/8/2019 2:20 PM
Contacts	Signed By	Insert	New Registration		Doyle, John CFO Central Washington Hospital 5094333809	8/7/2019 10:11 AM
Details	340B ID	Update	New Registration		DSH500016R	8/7/2019 10:11 AM
Details	Entity Name	Update	New Registration	CENTRAL WASHINGTON HOSPITAL	CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CENTRAL WASHINGTON HOSPITAL	8/7/2019 10:11 AM
Details	Entity Subname	Update	New Registration	Professional Building - OB/GYN	Professional Building - OB/GYN - OB/GYN	8/7/2019 10:11 AM
Dates	Participating Approval Date	Update	New Registration		8/7/2019 10:11:15 AM	8/7/2019 10:11 AM
Details	State	Update	New Registration	Pending	Approved	8/7/2019 10:11 AM
Dates	Signed By Date	Update	New Registration		7/2/2019 2:20:19 PM	8/7/2019 10:11 AM
Dates	Start Date	Update	New Registration		10/1/2019 12:00:00 AM	8/7/2019 10:11 AM
Addresses	Main Address	Insert	New Registration		933 Red Apple Rd Wenatchee, WA 98801	7/2/2019 2:20 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/2/2019 2:20 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1021258	7/2/2019 2:20 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		WA	7/2/2019 2:20 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1881642239	7/2/2019 2:20 PM
Contacts	Authorizing Official	Insert	New Registration		Doyle, John CFO Central Washington Hospital 5094333809	7/2/2019 2:20 PM
Contacts	Primary Contact	Insert	New Registration		Sieg, Michael Director of Pharmacy Central Washington Hospital 5094333556	7/2/2019 2:20 PM
Details	Last Recertification Date	Insert	New Registration			7/2/2019 2:20 PM
Details	Grant Number	Insert	New Registration			7/2/2019 2:20 PM
Details	340B ID	Insert	New Registration			7/2/2019 2:20 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/2/2019 2:20 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/2/2019 2:20 PM
Details	Medicare Provider Number	Insert	New Registration		500016	7/2/2019 2:20 PM
Details	Entity Name	Insert	New Registration		CENTRAL WASHINGTON HOSPITAL	7/2/2019 2:20 PM
Details	Program Code	Insert	New Registration		DSH	7/2/2019 2:20 PM
Details	Entity Subname	Insert	New Registration		Professional Building - OB/GYN	7/2/2019 2:20 PM
Dates	Participating Approval Date	Insert	New Registration			7/2/2019 2:20 PM
Details	State	Insert	New Registration		Pending	7/2/2019 2:20 PM
Dates	Registration Date	Insert	New Registration		7/2/2019 2:20:16 PM	7/2/2019 2:20 PM
Dates	Signed By Date	Insert	New Registration			7/2/2019 2:20 PM
Dates	Start Date	Insert	New Registration			7/2/2019 2:20 PM
Terminations	Termination Comments	Insert	New Registration			7/2/2019 2:20 PM
Terminations	Termination Date	Insert	New Registration			7/2/2019 2:20 PM
Terminations	Termination Effective Date	Insert	New Registration			7/2/2019 2:20 PM
Terminations	Termination Reason	Insert	New Registration			7/2/2019 2:20 PM