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DSH500088Z PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER (Terminated)
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Main Details
Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
North Benson Podiatry Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500088Z
Medicare Provider Number
500088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/6/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/17/2016
Last Recertification Date
9/13/2019
Termination Date
Termination Reason
10/1/2020
Site closure
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
10555 SE Carr Road
Building M
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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