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CREDENA HEALTH, LLC.
DSH500027 SWEDISH MEDICAL CENTER
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Covered Entity Details
Entity Name
SWEDISH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500027
Entity Address
747 BROADWAY
SEATTLE, WA 98122
Medicare Provider Number
500027
Participating Start Date
7/1/2006
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
CREDENA HEALTH, LLC.
Pharmacy Address
DBA CREDENA HEALTH PHARMACY FIRST HILL
747 BROADWAY STE ET-144
SEATTLE, WA 98122
Pharmacy Comments
Contract Details
Approval Date
3/4/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marybeth Formby, Chief Financial Officer
(206) 386-3033
Contract Pharmacy Representative
Providence
Tammy Pierce, Director of Pharmacy
(503) 962-1700
Signed By Date
3/4/2022
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