Covered Entity Details

DSH500129CN TACOMA GENERAL/ALLENMORE HOSPITAL (Active) - information as of 4/25/2025 6:36:17 PM

Main Details

Name

TACOMA GENERAL/ALLENMORE HOSPITAL

Subdivision Name

Tacoma General Emergency - Federal Way - TG Off Campus ED - FW

Type

Disproportionate Share Hospital

Rural

340B ID

DSH500129CN

Medicare Provider Number

500129

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/7/2022

Participating Start Date

10/1/2022

Participating Approval Date

8/10/2022

Last Recertification Date

8/14/2024

Contacts

Authorizing Official

MultiCare Health System
Timothy Wayne Lynch, Sr. VP, Chief Administrative Officer
(253) 403-2824

Primary Contact

MultiCare Health System
Cindy Wilson, Assistant Vice President - Pharmacy Compliance
(253) 403-2822

Addresses

Street Address

29805 Pacific Hwy S
Federal Way, WA 98003

Billing Address

MultiCare Health System
PO Box 5299
MS 1313-5-AP
Tacoma, WA 98415

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	1043908	1366556227,1841741311

Shipping Addresses

Shipping Address 1

Tacoma General Hospital
315 Martin Luther King Jr Way
Tacoma, WA 98405

Shipping Address 2

Tacoma General Emergency - Federal Way
29805 Pacific Hwy S
Federal Way, WA 98003

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
DSH500129AA	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	AHC AMBULATORY INFUSION SUITE	3124 S. 19th Street	Tacoma	WA	Active
DSH500129AC	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MultiCare Obgyn Associate II Clinic	521 Martin Luther King Jr Way	Tacoma	WA	Terminated
DSH500129AE	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	CT Scan Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AF	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MRI Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AG	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Imaging Services Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AH	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Nuclear Medicine Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AJ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Heart and Lung Center	1901 South Union Ave	Tacoma	WA	Active
DSH500129AK	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV SHORT STAY UNIT	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129AL	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD CT SCAN	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AM	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH PACU	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AN	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH OR	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AP	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD RADIATION THERAPY	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AQ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD MRI	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AR	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD DIABETES SVCS	4545 Point Fosdick Rd NW	Gig Harbor	WA	Active
DSH500129AS	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD DIAGNOSTIC IMAGING	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AT	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH PHARMACEUTICAL RESOURCE CLINIC	4545 Point Fosdick Drive NW, STE 260	Gig Harbor	WA	Terminated
DSH500129AU	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH ONC ACUPUNCTURE	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AV	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH MULTI-SPECIALTY PROCEDURE CENTER	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AW	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH SURGICAL ADMISSION UNIT	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AX	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH ONC BREAST SURGEONS	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129BA	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB HSD RADIATION THERAPY	121 North Division St #100	AUBURN	WA	Active
DSH500129BB	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB ONC BREAST SURGEONS	121 North Division St #100	AUBURN	WA	Active
DSH500129BC	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB HSD HEM/ONC LAB	121 North Division St #100	AUBURN	WA	Terminated
DSH500129BD	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB ONC INTERNAL MEDICINE	121 North Division St #100/200	AUBURN	WA	Active
DSH500129BF	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV PACU 1	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BG	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV PACU 2	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BH	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD MRI	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BK	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD ULTRASOUND	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BM	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV EMERGENCY DEPARTMENT	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BP	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH DIAGNOSTIC IMAGING	1901 South Union	TACOMA	WA	Active
DSH500129BQ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG INTERVENTIONAL ENDOSCOPY	316 Martin Luther King Jr Way	TACOMA	WA	Active
DSH500129BR	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH INTERVENTIONAL ENDOSCOPY	1901 South Union	TACOMA	WA	Active
DSH500129BS	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH ULTRASOUND	1901 South Union	TACOMA	WA	Active
DSH500129BT	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG WG WESTGATE LAB	2209 North Pearl Suite 100	TACOMA	WA	Terminated
DSH500129BU	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AHC CLAB ALLENMORE C LAB	3124 S 19th Street	TACOMA	WA	Terminated
DSH500129BV	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG BAKER DIAGNOSTIC IMAGING	316 Martin Luther King Jr Way	TACOMA	WA	Active
DSH500129BW	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG TRAUMA FOLLOWUP - BAKER	316 MARTIN LUTHER KING JR.WAY	TACOMA	WA	Active
DSH500129BX	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - MB LAB	317 Martin Luther King Jr Way	TACOMA	WA	Terminated
DSH500129BY	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG LAKEWOOD DIABETES SERVICES	735 12th Street SE	AUBURN	WA	Terminated
DSH500129BZ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV OR	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CA	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG SPANAWAY DIABETES SERVICES	225 176th St S	SPANAWAY	WA	Terminated
DSH500129CB	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD DIAGNOSTIC IMAGING	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CC	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH DIABETES SERVICES	3124 South 19th, Suite 140	TACOMA	WA	Terminated
DSH500129CD	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH NUCLEAR MED	1901 South Union	TACOMA	WA	Active
DSH500129CE	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD CT SCAN	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CF	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH ECHO	1901 South Union-	TACOMA	WA	Active
DSH500129CG	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD DIABETES SVCS	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CH	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH Medication Management Clinic	1901 South Union- BUILDING B, SUITE #7009	TACOMA	WA	Active
DSH500129CJ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB HSD DIABETES SERVICES	735 12th Street SE	AUBURN	WA	Terminated
DSH500129CK	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MultiCare Neuroscience & Sleep Medicine - TG Neurology	915 6th Avenue	Tacoma	WA	Active
DSH500129CL	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Multicare Rheumatology Specialists - Multicare Rheumatology Specialists	1901 S. Cedar St.	Tacoma	WA	Active
DSH500129CM	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MultiCare Neuroscience & Sleep Medicine - TG NEUROSURGERY CLINIC	915 6TH Ave	Tacoma	WA	Active
DSH500129CN	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Tacoma General Emergency - Federal Way - TG Off Campus ED - FW	29805 Pacific Hwy S	Federal Way	WA	Active
DSH500129CP	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Hospital PET/CT - AHC PET/CT	3124 S 19th	Tacoma	WA	Active
DSH500129E	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Tacoma Family Medicine Clinic	521 MARTIN LUTHER KING JR WAY	TACOMA	WA	Terminated
DSH500129F	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE REGIONAL CANCER CENTER - GIG HARBOR	4545 POINT FOSDICK DR NW Suite 215	GIG HARBOR	WA	Active
DSH500129G	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE REGIONAL CANCER CENTER - AUBURN	121 N. Division Street Suite 100	AUBURN	WA	Active
DSH500129H	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE REGIONAL CANCER CENTER - PUYALLUP	400 15TH AVE SE	PUYALLUP	WA	Active
DSH500129J	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Baker Center Ambulatory Surgery Center	316 Martin Luther King Jr Way	Tacoma	WA	Active
DSH500129K	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Day Surgery of Tacoma-PACU	316 Martin Luther King Jr Way	Tacoma	WA	Active
DSH500129L	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Interventional Pain Management	316 Martin Luther King Jr Way	Tacoma	WA	Active
DSH500129M	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	OB Access Clinic	521 Martin Luther King Jr Way	Tacoma	WA	Terminated
DSH500129Q	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Campus	1901 S Union Ave	Tacoma	WA	Active
DSH500129R	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Short Stay Unit	1901 S Union Ave	Tacoma	WA	Active
DSH500129S	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Emergency Department	1901 S Union Ave	Tacoma	WA	Active
DSH500129T	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Surgery (Operating Room)	1901 S Union Ave	Tacoma	WA	Active
DSH500129U	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore PACU	1901 S Union Ave	Tacoma	WA	Active
DSH500129W	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore MRI	1901 S Union Ave	Tacoma	WA	Active
DSH500129X	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Radiology	1901 S Union Ave	Tacoma	WA	Active
DSH500129Y	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore CT Scan	1901 S Union Ave	Tacoma	WA	Active
DSH500129Z	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Interventional Radiology	1901 S Union Ave	Tacoma	WA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/5/2023 12:11:46 PM	8/14/2024 9:48:48 PM	8/14/2024 9:48 PM
Details	Last Recertification Date	Update	Recertification		9/5/2023 12:11:46 PM	9/5/2023 12:11 PM
Contacts	Authorizing Official	Update	AO Change Request	Chang, Florence President MULTICARE HEALTH SYSTEM 2534037355	Lynch, Timothy Wayne Sr. VP, Chief Administrative Officer MultiCare Health System 2534032824	11/4/2022 8:08 AM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Chang, Florence President MULTICARE HEALTH SYSTEM 2534037355	8/10/2022 11:37 AM
Details	340B ID	Update	New Registration		DSH500129CN	8/10/2022 11:37 AM
Details	Entity Subname	Update	New Registration	Tacoma General Emergency - Federal Way	Tacoma General Emergency - Federal Way - TG Off Campus ED - FW	8/10/2022 11:37 AM
Dates	Participating Approval Date	Update	New Registration		8/10/2022 11:37:45 AM	8/10/2022 11:37 AM
Details	State	Update	New Registration	Pending	Approved	8/10/2022 11:37 AM
Dates	Signed By Date	Update	New Registration		7/8/2022 1:59:29 AM	8/10/2022 11:37 AM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	8/10/2022 11:37 AM
Addresses	Main Address	Insert	New Registration		29805 Pacific Hwy S Federal Way, WA 98003	7/7/2022 3:57 PM
Addresses	Billing Address	Insert	New Registration		MultiCare Health System PO Box 5299 MS 1313-5-AP Tacoma, WA 98415	7/7/2022 3:57 PM
Addresses	Shipping Address	Insert	New Registration		Tacoma General Hospital 315 Martin Luther King Jr Way Tacoma, WA 98405	7/7/2022 3:57 PM
Addresses	Shipping Address	Insert	New Registration		Tacoma General Emergency - Federal Way 29805 Pacific Hwy S Federal Way, WA 98003	7/7/2022 3:57 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/7/2022 3:57 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1043908	7/7/2022 3:57 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		WA	7/7/2022 3:57 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1366556227	7/7/2022 3:57 PM
Medicaid Billing	NPI: State	Insert	New Registration		WA	7/7/2022 3:57 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1841741311	7/7/2022 3:57 PM
Medicaid Billing	NPI: State	Insert	New Registration		WA	7/7/2022 3:57 PM
Contacts	Authorizing Official	Insert	New Registration		Chang, Florence President MULTICARE HEALTH SYSTEM 2534037355	7/7/2022 3:57 PM
Contacts	Primary Contact	Insert	New Registration		Wilson, Cindy Assistant Vice President - Pharmacy Compliance MultiCare Health System 2534032822	7/7/2022 3:57 PM
Details	Assistance Received From Date	Insert	New Registration			7/7/2022 3:57 PM
Details	Assistance Received To Date	Insert	New Registration			7/7/2022 3:57 PM
Details	Last Recertification Date	Insert	New Registration			7/7/2022 3:57 PM
Details	Grant Number	Insert	New Registration			7/7/2022 3:57 PM
Details	340B ID	Insert	New Registration			7/7/2022 3:57 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/7/2022 3:57 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/7/2022 3:57 PM
Details	Medicare Provider Number	Insert	New Registration		500129	7/7/2022 3:57 PM
Details	Entity Name	Insert	New Registration		TACOMA GENERAL/ALLENMORE HOSPITAL	7/7/2022 3:57 PM
Details	NOFO Number	Insert	New Registration			7/7/2022 3:57 PM
Details	Program Code	Insert	New Registration		DSH	7/7/2022 3:57 PM
Details	Entity Subname	Insert	New Registration		Tacoma General Emergency - Federal Way	7/7/2022 3:57 PM
Dates	Participating Approval Date	Insert	New Registration			7/7/2022 3:57 PM
Details	State	Insert	New Registration		Pending	7/7/2022 3:57 PM
Dates	Registration Date	Insert	New Registration		7/7/2022 3:57:24 PM	7/7/2022 3:57 PM
Dates	Signed By Date	Insert	New Registration			7/7/2022 3:57 PM
Dates	Start Date	Insert	New Registration			7/7/2022 3:57 PM
Terminations	Termination Comments	Insert	New Registration			7/7/2022 3:57 PM
Terminations	Termination Date	Insert	New Registration			7/7/2022 3:57 PM
Terminations	Termination Effective Date	Insert	New Registration			7/7/2022 3:57 PM
Terminations	Termination Reason	Insert	New Registration			7/7/2022 3:57 PM