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MULTICARE CLINIC PHARMACY
DSH500129 TACOMA GENERAL/ALLENMORE HOSPITAL
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Covered Entity Details
Entity Name
TACOMA GENERAL/ALLENMORE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500129
Entity Address
315 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405-4234
Medicare Provider Number
500129
Participating Start Date
12/1/2005
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
MULTICARE CLINIC PHARMACY
Pharmacy Address
521 Martin Luther King Jr Way
Tacoma, WA 98405
Pharmacy Comments
Contract Details
Approval Date
4/17/2020
Contract Begin Date
4/21/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Florence Chang, President
(253) 403-7355
Contract Pharmacy Representative
Multicare Health System
Teresa Harberg, Director of Ambulatory Pharmacy
(253) 403-2283
Signed By Date
4/17/2020
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