340B Drug Pricing Program Database
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DSH500079H GOOD SAMARITAN HOSPITAL (Active)
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Main Details
Name
GOOD SAMARITAN HOSPITAL
Subdivision Name
MultiCare GSH South Hill Emergency - Emergency
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH500079H
Medicare Provider Number
500079
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/4/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/7/2022
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
MultiCare Health System
Timothy Wayne Lynch, Sr. VP, Chief Administrative Officer
(253) 403-2824
Primary Contact
MultiCare Health System
Cindy Wilson, Assistant Vice President - Pharmacy Compliance
(253) 403-2822
Addresses
Street Address
13106 Meridian Ave E
Puyallup, WA 98373
Billing Address
MultiCare Health System
PO Box 5299
MS 1313-5-AP
Tacoma, WA 98415-0299
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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