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DSH500058Q Kadlec Regional Medical Center (Terminated)
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Main Details
Name
Kadlec Regional Medical Center
Subdivision Name
Associated Physicians for Women Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500058Q
Medicare Provider Number
500058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/4/2014
Last Recertification Date
9/10/2021
Termination Date
Termination Reason
4/1/2022
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Kadlec Regional Medical Center
Spencer Dwayne Harris, CFO
(509) 942-2708
Primary Contact
Kadlec Regional Medical Center
C.J. Cahoon, Director of Pharmacy
(509) 946-4611 Ext: 4263
Addresses
Street Address
945 Goethals Drive
Suite 200
Richland, WA 99352
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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