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DSH500058T KADLEC REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
KADLEC REGIONAL MEDICAL CENTER
Subdivision Name
OP Oncology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500058T
Medicare Provider Number
500058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/13/2015
Last Recertification Date
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Kadlec Regional Medical Center
Spencer Dwayne Harris, CFO
(509) 942-2708
Primary Contact
David Pearson, Pharmacy Director
(509) 946-4611 Ext: 4263
Addresses
Street Address
888 Swift Boulevard
Richland, WA 99352
Billing Address
Kadlec Regional Medical Center
888 Swift Boulevard
Attn: Pharmacy Dept
Richland, WA 99352
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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