340B Drug Pricing Program Database
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DSH500050J PeaceHealth Southwest Medical Center (Active)
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Main Details
Name
PeaceHealth Southwest Medical Center
Subdivision Name
Diabetes & Endocrinology Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500050J
Medicare Provider Number
500050
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/2/2024
Participating Start Date
4/1/2024
Participating Approval Date
3/8/2024
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
PeaceHealth, Columbia Network
Tracey Fernandez, CFO
(360) 514-3548
Primary Contact
PeaceHealth
Adriane Kindell, 340B Program Supervisor
(360) 414-2137
Addresses
Street Address
2312 NE 129th St
Suite 120
Vancouver, WA 98686
Billing Address
PeaceHealth
1115 SE 164th Ave
Ste. 332
Vancouver, WA 98683
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2013, terminated 1/1/2020. Reinstated 4/1/2024.
01/31/2024
April 2025
April 2025
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