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DSH500036G YAKIMA VALLEY MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
NSL Oncology Facility - Sunnyside
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036G
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
Site closure
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
1812 E. Edison Ave.
Sunnyside, WA 98944
Billing Address
Yakima Valley Memorial Hospital
2811 Tieton Drive
Yakima, WA 98902
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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