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AIDS HEALTHCARE FOUNDATION
DSH500064 HARBORVIEW MEDICAL CENTER
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Covered Entity Details
Entity Name
HARBORVIEW MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500064
Entity Address
325 9TH AVE.
SEATTLE, WA 98104-2499
Medicare Provider Number
500064
Participating Start Date
12/1/1992
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
AIDS HEALTHCARE FOUNDATION
Pharmacy Address
AHF PHARMACY
1016 E PIKE ST STE 100
SEATTLE, WA 98122
Pharmacy Comments
Contract Details
Approval Date
1/14/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/27/2024
Ownership change
Contacts
Covered Entity Signing Official
Lori Mitchell, CFO, UW Medicine
(206) 616-9886
Contract Pharmacy Representative
aidshealth
SCOTT CARRUTHERS, SR. MANAGER, CHIEF PHARMACY OFFICER
(323) 860-5200 Ext: 5266
Signed By Date
1/14/2014
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