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DSH500088AP PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER (Active)
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Main Details
Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
Valley Medical Center: - Radiation Oncology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500088AP
Medicare Provider Number
500088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/6/2020
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Public Hospital District No 1 of King County
Jeannine Grinnell, Chief Executive and Financial Officer
(425) 690-3310
Primary Contact
Public Hospital District No. 1 of King County
Kenneth Kenyon, VP Pharmacy Services
(425) 690-3155
Addresses
Street Address
400 South 43rd Street
Renton, WA 98055
Billing Address
Public Hospital District No. 1 of King County DBA Valley Medical Center
PO Box 50010
400 South 43rd Street
Renton, WA 98058
Comments
Medicaid Billing
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Contract Pharmacies
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