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DSH500036L YAKIMA VALLEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
Waters Edge Pain Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036L
Medicare Provider Number
500036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/13/2013
Last Recertification Date
8/17/2024
Contacts
Authorizing Official
Yakima Valley Memorial Hospital
Tammy K. Buyok, President and Market Leader
(509) 575-8001
Primary Contact
Yakima Valley Memorial Hospital
Jake Aaron Bradshaw, Director of Pharmacy
(509) 746-2002
Addresses
Street Address
1460 N. 16th Avenue
Suite D
Yakima, WA 98902
Billing Address
Yakima Valley Memorial Hospital
PO Box: 5299
MS 1313-5-AP
Tacoma, WA 98415-0299
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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