340B Drug Pricing Program Database
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RRC500024-00 PROVIDENCE ST. PETER HOSPITAL (Active)
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Main Details
Name
PROVIDENCE ST. PETER HOSPITAL
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC500024-00
Medicare Provider Number
500024
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/26/2020
Last Recertification Date
9/11/2024
Contacts
Authorizing Official
Providence Health & Services
Marna Leonard, Chief Financial Officer
(206) 992-8229
Primary Contact
Providence St. Peter Hospital
Andrea Christan Hall, Senior Manager Pharmacy Ambulatory
(360) 523-2953
Addresses
Street Address
413 LILLY ROAD NE
OLYMPIA, WA 98506
Billing Address
Providence Health & Services
PO BOX 31263
Salt Lake City, UT 84131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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