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DSH500027J SWEDISH MEDICAL CENTER (Terminated)
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Main Details
Name
SWEDISH MEDICAL CENTER
Subdivision Name
True Center Breast Imaging
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500027J
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
8/30/2020
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
1221 Madison St
Suite 600
Seattle, WA 98104
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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