340B Drug Pricing Program Database
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DSH500044J DEACONESS MEDICAL CENTER (Terminated)
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Main Details
Name
DEACONESS MEDICAL CENTER
Subdivision Name
Cancer&Blood Spec Spokane Valley DHS - Cancer and Blood Specialty Clinics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500044J
Medicare Provider Number
500044
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/11/2019
Last Recertification Date
8/31/2021
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
MULTICARE HEALTH SYSTEM
Florence Chang, President
(253) 403-7355
Primary Contact
MultiCare Health System
Maria Campanella, Director 340B Program
(253) 403-8314
Addresses
Street Address
12410 E Sinto Ave. Suite 101
Spokane Valley, WA 99216
Billing Address
MULTICARE HEALTH SYSTEM
PO Box 5299
MS 1313-5-AP
Tacoma, WA 98415-0299
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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