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DSH500008P UNIVERSITY OF WASHINGTON MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF WASHINGTON MEDICAL CENTER
Subdivision Name
Sports and Spine Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500008P
Medicare Provider Number
500008
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/14/2013
Last Recertification Date
8/6/2015
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
UW Medicine
MAUREEN BROOM, Enterprise Finance Officer
(206) 598-5362
Primary Contact
Donald L. Bomgaars, Director of Pharmacy Services, Supply Chain Management & Contracts, UW Medicine
(206) 598-6055
Addresses
Street Address
4245 Roosevelt Way NE
Seattle, WA 98105
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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