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DSH500003AH SKAGIT VALLEY HOSPITAL (Terminated)
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Main Details
Name
SKAGIT VALLEY HOSPITAL
Subdivision Name
Skagit Regional Clinics Mount Vernon-Optometry
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500003AH
Medicare Provider Number
500003
Outpatient Facility Provider Number
500003
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
Skagit Valley Hospital
Paul Ishizuka, CFO
(360) 814-5838
Primary Contact
Skagit Valley Hospital.
Alma Martinez, 340B Program Manager
(360) 814-5001
Addresses
Street Address
1400 East Kincaid St
Mount Vernon, WA 98274
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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