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DSH500053AJ KENNEWICK GENERAL HOSPITAL (Terminated)
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Main Details
Name
KENNEWICK GENERAL HOSPITAL
Subdivision Name
TRIOS HEALTH CENTER AT SOUTHRIDGE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500053AJ
Medicare Provider Number
500053
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/11/2016
Last Recertification Date
12/6/2017
Termination Date
Termination Reason
10/1/2018
For-Profit conversion
Contacts
Authorizing Official
RCCH Trios Health, LLC
Jason Hotchkiss, CFO
(509) 221-5735
Primary Contact
Kennewick Public Hospital District
MICHAEL Robert-Reece PORTER, DIRECTOR OF PHARMACY
(509) 221-5788
Addresses
Street Address
3730 PLAZA WAY
KENNEWICK, WA 99336-0128
Billing Address
Kennewick General Hoospital
900 South Auburn Street
Kennewick, WA 99336
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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