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DSH500027AJ SWEDISH MEDICAL CENTER (Terminated)
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Main Details
Name
SWEDISH MEDICAL CENTER
Subdivision Name
SCI Ballard, Radiation Treatment Center/21576420
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500027AJ
Medicare Provider Number
500027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/15/2015
Last Recertification Date
8/31/2020
Termination Date
Termination Reason
7/1/2021
Site closure
Contacts
Authorizing Official
Swedish Medical Center
Marybeth Formby, Chief Financial Officer
(206) 386-3033
Primary Contact
Providence/Swedish
Melisa G Lea, 340B Program Manager
(206) 756-0546
Addresses
Street Address
5225 Tallman Ave NW
Seattle, WA 98107
Billing Address
Swedish Health Services Accounts Payable
PO BOX 389673
Seattle, WA 98138-9673
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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