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OPTION CARE ENTERPRISES, INC.
DSH500003 SKAGIT VALLEY HOSPITAL
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Covered Entity Details
Entity Name
SKAGIT VALLEY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500003
Entity Address
1415 EAST KINCAID
MOUNT VERNON, WA 98274-4126
Medicare Provider Number
500003
Participating Start Date
7/1/2006
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
D/B/A OPTION CARE
600 BIRCHWOOD AVE
SUITE 100
BELLINGHAM, WA 98225-1757
Pharmacy Comments
Contract Details
Approval Date
4/12/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/14/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
THOMAS LITAKER, CFO
(360) 445-8505
Contract Pharmacy Representative
Option Care
Shanna Brown, Business Analyst
(602) 453-2013
Signed By Date
4/12/2016
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