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DSH500088W PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER (Active)
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Main Details
Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
The Breast Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500088W
Medicare Provider Number
500088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/4/2015
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Public Hospital District No 1 of King County
Jeannine Grinnell, Chief Executive and Financial Officer
(425) 690-3310
Primary Contact
Public Hospital District No. 1 of King County
Kenneth Kenyon, VP Pharmacy Services
(425) 690-3155
Addresses
Street Address
4033 Talbot Road South Suite 470
Renton, WA 98055
Billing Address
Public Hospital District No 1 of King County dba Valley Medical Center
PO Box 50010
400 S 43rd St.
Renton, WA 98058
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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