340B Drug Pricing Program Database
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DSH500036F YAKIMA VALLEY MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
NSL Oncology Facility Ellensburg
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036F
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
8/31/2021
Termination Date
Termination Reason
4/1/2022
Business decision by the Covered Entity
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
100 E. Jackson Avenue
Suite 104
Ellensburg, WA 98926-3693
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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