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WENATCHEE CLINIC PHARMACY
DSH500016 CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL
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Covered Entity Details
Entity Name
CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION DBA CONFLUENCE HEALTH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500016
Entity Address
1201 SOUTH MILLER STREET
WENATCHEE, WA 98801
Medicare Provider Number
500016
Participating Start Date
4/1/2009
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
WENATCHEE CLINIC PHARMACY
Pharmacy Address
9TH & CHELAN ST
PO BOX 879
WENATCHEE, WA 98807
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/3/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Doyle, CFO
(509) 433-3809
Contract Pharmacy Representative
Wenatchee Clinic Pharmacy
Dale Murray, Owner
(509) 662-5801
Signed By Date
10/14/2019
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