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DSH500027V SWEDISH MEDICAL CENTER (Terminated)
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Main Details
Name
SWEDISH MEDICAL CENTER
Subdivision Name
Swedish Cancer Rehabilitation Services
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500027V
Medicare Provider Number
500027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/15/2015
Last Recertification Date
8/21/2018
Termination Date
Termination Reason
1/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Swedish Health Services
Pam Gallagher Felt, CFO Swedish Dwtwn Acute PSJH
(206) 628-2541
Primary Contact
Swedish Health Services
Jim Lacy, System Director of Pharmacy Services
(206) 320-2276
Addresses
Street Address
1229 Madison St
Suite 1050
Seattle, WA 98104
Billing Address
Swedish Medical Center
747 Broadway
Seattle, WA 98122
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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