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DSH500064P HARBORVIEW MEDICAL CENTER (Active)
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Main Details
Name
HARBORVIEW MEDICAL CENTER
Subdivision Name
Vascular Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500064P
Medicare Provider Number
500064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/10/2013
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
UW Medicine
Jacqueline L Cabe, Chief Financial Officer
(206) 616-9886
Primary Contact
UW Medicine
Sumona Patel, Pharmacy Audit and Compliance Manager
(206) 598-6936
Addresses
Street Address
908 Jefferson St
Seattle, WA 98104
Billing Address
UW Medicine
PO BOX 45404
Seattle, WA 98145
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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