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DSH500064AL HARBORVIEW MEDICAL CENTER (Terminated)
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Main Details
Name
HARBORVIEW MEDICAL CENTER
Subdivision Name
HCSAT Medicine Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500064AL
Medicare Provider Number
500064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
Termination Date
Termination Reason
7/1/2015
Site closure
Contacts
Authorizing Official
UW Medicine
MAUREEN BROOM, Enterprise Finance Officer
(206) 598-5362
Primary Contact
Lori Mitchell, CFO, UW Medicine
(206) 616-9886
Addresses
Street Address
401 Broadway
Seattle, WA 98104-2499
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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