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ARDON HEALTH, LLC
DSH500088 PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
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Covered Entity Details
Entity Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500088
Entity Address
400 S 43RD STREET
RENTON, WA 98055-5010
Medicare Provider Number
500088
Participating Start Date
10/4/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ARDON HEALTH, LLC
Pharmacy Address
11835 NE GLENN WIDING DR
PORTLAND, OR 97220-9057
Pharmacy Comments
Contract Details
Approval Date
7/12/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeannine Grinnell, Chief Executive and Financial Officer
(425) 690-3310
Contract Pharmacy Representative
Ardon Health
Grant E Knowles, VP
(503) 444-6501
Signed By Date
7/12/2020
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