340B Drug Pricing Program Database
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DSH500036W YAKIMA VALLEY MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
Yakima Vascular Associates
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036W
Medicare Provider Number
500036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/15/2017
Last Recertification Date
9/7/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Yakima Valley Memorial Hospital
Tammy K. Buyok, President and Market Leader
(509) 575-8001
Primary Contact
Yakima Valley Memorial Hospital
Michael Hull, Director of Pharmacy
(509) 249-5227
Addresses
Street Address
406 S. 30th Ave.
101
Yakima, WA 98902
Billing Address
Yakima Valley Memorial Hospital
2811 Tieton Drive
Yakima, WA 98902
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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