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DSH500036H YAKIMA VALLEY MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
Cancer Care Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036H
Medicare Provider Number
500036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/6/2013
Last Recertification Date
9/4/2020
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
YVMH
Thomas M McDonagh, CFO
(509) 575-8980
Primary Contact
Yakima Valley Memorial Hospital
Michael Hull, Director of Pharmacy
(509) 249-5227
Addresses
Street Address
808 N. 39th Avenue
Yakima, WA 98902
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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