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DSH500036AE YAKIMA VALLEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
YAKIMA VALLEY MEMORIAL HOSPITAL
Subdivision Name
NSL Radiation Oncology - Radiation Therapy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500036AE
Medicare Provider Number
500036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/27/2021
Last Recertification Date
8/17/2024
Contacts
Authorizing Official
Yakima Valley Memorial Hospital
Tammy K. Buyok, President and Market Leader
(509) 575-8001
Primary Contact
Yakima Valley Memorial Hospital
Jake Aaron Bradshaw, Director of Pharmacy
(509) 746-2002
Addresses
Street Address
808 N. 39th Ave
Yakima, WA 98902
Billing Address
Yakima Valley Memorial Hospital
PO Box: 5299
MS 1313-5-AP
Tacoma, WA 98415-0299
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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