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DSH500008C UNIVERSITY OF WASHINGTON MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF WASHINGTON MEDICAL CENTER
Subdivision Name
Psychiatry Clinic Rsvlt
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500008C
Medicare Provider Number
500008
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/30/2021
Participating Start Date
10/1/2021
Participating Approval Date
8/31/2021
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
4225 Roosevelt Way NE
Seattle, WA 98105
Billing Address
UW Medicine
PO BOX 45404
Seattle, WA 98145
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2013, terminated 7/1/2021. Reinstated 10/1/2021.
08/31/2021
May 2025
May 2025
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