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DSH500008EJ UNIVERSITY OF WASHINGTON MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF WASHINGTON MEDICAL CENTER
Subdivision Name
RADIOLOGY - DIAGNOSTIC - ECHOCARDIOGRAPHY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500008EJ
Medicare Provider Number
500008
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2021
Participating Start Date
4/1/2021
Participating Approval Date
3/5/2021
Last Recertification Date
8/30/2021
Termination Date
Termination Reason
4/1/2022
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
UW Medicine
MAUREEN BROOM, Enterprise Finance Officer
(206) 598-5362
Primary Contact
UW Medicine
Sumona Patel, Pharmacy Audit and Compliance Manager
(206) 598-6936
Addresses
Street Address
1550 N 115th St
Seattle, WA 98133
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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