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DSH500088M PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER (Terminated)
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Main Details
Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
Correctional Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500088M
Medicare Provider Number
500088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/3/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/14/2014
Last Recertification Date
8/23/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Public Hospital District No 1 of King County
Jeannine Grinnell, Chief Executive and Financial Officer
(425) 690-3310
Primary Contact
Public Hospital District No. 1 of King County
Kenneth Kenyon, VP Pharmacy Services
(425) 690-3155
Addresses
Street Address
3915 Talbot Road South
Suite 401
Renton, WA 98055
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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