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CORAM ALTERNATE SITE SERVICES, INC.
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
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
5511 E 3RD AVE
SPOKANE VALLEY, WA 99212-0726
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Sheri Feeney, Chief Financial Officer
(206) 628-2530
Contract Pharmacy Representative
CVS Health/Specialty
Jen Jagodzinski, Senior Director, Specialty Product Development
(847) 559-4702
Signed By Date
7/17/2017
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