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DSH500008E UNIVERSITY OF WASHINGTON MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF WASHINGTON MEDICAL CENTER
Subdivision Name
Virology Clinic at UWMC-Roosevelt
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500008E
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
8/21/2014
Termination Date
Termination Reason
7/1/2015
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 AND 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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