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CAH501338-00 PUBLIC HOSPITAL DISTRICT #4 KING COUNTY WASHINGTON (Active)
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Main Details
Name
PUBLIC HOSPITAL DISTRICT #4 KING COUNTY WASHINGTON
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH501338-00
Medicare Provider Number
501338
Additional Details
Current Program Status
Active
Registration Date
6/14/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/14/2011
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Snoqualmie Valley Health
Jeremy Storm, CMO
(425) 414-9034
Primary Contact
Snoqualmie Valley Hospital
Corinne Dolan, Pharmacy Manager
(425) 831-2375
Addresses
Street Address
9801 Frontier Ave SE
SNOQUALMIE, WA 98065
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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