340B Drug Pricing Program Database

Name

PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER

Subdivision Name

VMC Specialty Care Clinics - - Allergy and Immunology Clinic, Covington

Type

Disproportionate Share Hospital

Rural

No

340B ID

DSH500088AS

Medicare Provider Number

500088

Outpatient Facility Provider Number

Current Program Status

Terminated

Registration Date

1/14/2021

Participating Start Date

2/16/2021

Participating Approval Date

1/25/2021

Last Recertification Date

9/2/2021

Termination Date
Termination Reason

10/1/2022
Business decision by the Covered Entity

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

Street Address

16850 SE 272nd Street, Suite 100
Covington, WA 98042-4931

Billing Address

Public Hospital District No. 1 of King County DBA Valley Medical Center
400 South 43rd Street
PO Box 50010
Renton, WA 98058