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CAH501333-00 KITTITAS COUNTY PUBLIC HOSPITAL DISTRICT #1 (Active)
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Main Details
Name
KITTITAS COUNTY PUBLIC HOSPITAL DISTRICT #1
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH501333-00
Medicare Provider Number
501333
Additional Details
Current Program Status
Active
Registration Date
8/25/2010
Participating Start Date
8/25/2010
Participating Approval Date
8/25/2010
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Kittitas Valley Healthcare
Rhonda Holden, Chief Ancillary Officer
(509) 962-7320
Primary Contact
Kittitas Valley Healthcare Hospital
Nasser Basmeh, Director of Pharmacy
(509) 962-7420
Addresses
Street Address
603 S CHESTNUT ST
ELLENSBURG, WA 98926
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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