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DSH500036Q YAKIMA VALLEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
Lakeview Spine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036Q
Medicare Provider Number
500036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/15/2017
Last Recertification Date
8/17/2024
Contacts
Authorizing Official
Yakima Valley Memorial Hospital
Tammy K. Buyok, President and Market Leader
(509) 575-8001
Primary Contact
Yakima Valley Memorial Hospital
Jake Aaron Bradshaw, Director of Pharmacy
(509) 746-2002
Addresses
Street Address
1470 North 16th Avenue, Suite D
Yakima, WA 98902
Billing Address
Yakima Valley Memorial Hospital
PO Box: 5299
MS 1313-5-AP
Tacoma, WA 98415-0299
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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