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RRC500005-27 VIRGINIA MASON MEDICAL CENTER (Terminated)
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Main Details
Name
VIRGINIA MASON MEDICAL CENTER
Subdivision Name
CONCIERGE MEDICINE (Lindeman) - CONCIERGE MEDICINE (Lindeman)
Type
Rural Referral Center
Rural
No
340B ID
RRC500005-27
Medicare Provider Number
500005
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/11/2023
Last Recertification Date
Termination Date
Termination Reason
1/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Virginia Mason Franciscan Health
David Nosacka, SVP and CFO
(253) 680-4005
Primary Contact
Virginia Mason Medical Center
Laurel Anne Brown, Director of Pharmacy
(206) 583-6015
Addresses
Street Address
1201 Terry Ave
Seattle, WA 98101
Billing Address
Virginia Mason Medical Center
925 Seneca St
Mailstop H3-PI
Seattle, WA 98101
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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