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DSH500129E TACOMA GENERAL/ALLENMORE HOSPITAL (Terminated)
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Main Details
Name
TACOMA GENERAL/ALLENMORE HOSPITAL
Subdivision Name
Tacoma Family Medicine Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500129E
Medicare Provider Number
500129
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/1/2005
Participating Start Date
12/1/2005
Participating Approval Date
12/1/2005
Last Recertification Date
8/27/2014
Termination Date
Termination Reason
7/1/2015
Site closure
Contacts
Authorizing Official
MULTICARE HEALTH SYSTEM
Florence Chang, President
(253) 403-7355
Primary Contact
MultiCare Health System
Tom Rowe, Director, Phamacy Acute Care
(253) 403-1629
Addresses
Street Address
521 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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03/20/2014: Termination recorded in error; site remained continuously eligible from participation start date.
03/31/2014
April 2025
April 2025
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