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DSH500058V KADLEC REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
KADLEC REGIONAL MEDICAL CENTER
Subdivision Name
Associated Physicians for Women Clinic – Satellite
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500058V
Medicare Provider Number
500058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/27/2016
Last Recertification Date
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
Kadlec Regional Medical Center
Spencer Dwayne Harris, CFO
(509) 942-2708
Primary Contact
Kadlec Regional Medical Center
C.J. Cahoon, Pharmacy Director
(509) 946-4611 Ext: 4263
Addresses
Street Address
112 Columbia Point Dr., Ste. 101
Richland, WA 99352
Billing Address
Kadlec Regional Medical Center
888 Swift Blvd
Attn: Pharmacy Dept
Richland, WA 99352
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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