340B Drug Pricing Program Database
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DSH500008AM UNIVERSITY OF WASHINGTON MED CTR (Terminated)
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Main Details
Name
UNIVERSITY OF WASHINGTON MED CTR
Subdivision Name
UWMC Hec Ed Pavilion / ER Med Svc
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500008AM
Medicare Provider Number
500008
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/10/2015
Last Recertification Date
8/6/2015
Termination Date
Termination Reason
1/1/2016
Loss of qualifying grant/support
Contacts
Authorizing Official
UW Medicine
MAUREEN BROOM, Enterprise Finance Officer
(206) 598-5362
Primary Contact
Donald L. Bomgaars, Director of Pharmacy Services, Supply Chain Management & Contracts, UW Medicine
(206) 598-6055
Addresses
Street Address
3870 Montlake Blvd NE
Seattle, WA 98105
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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