340B Drug Pricing Program Database
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DSH500058AV Kadlec Regional Medical Center (Terminated)
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Main Details
Name
Kadlec Regional Medical Center
Subdivision Name
KADLEC CLINIC URGENT CARE - Urgent Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH500058AV
Medicare Provider Number
500058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/31/2017
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
7/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Kadlec Regional Medical Center
Spencer Dwayne Harris, CFO
(509) 942-2708
Primary Contact
Kadlec Regional Medical Center
C.J. Cahoon, Director of Pharmacy
(509) 946-4611 Ext: 4263
Addresses
Street Address
4804W CLEARWATER AVE
KENNEWICK, WA 99336-2119
Billing Address
KRMC Pharmacy Dept
888 Swift Boulevard
Richland, WA 99352
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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