Contract Pharmacy Details

OPTION CARE ENTERPRISES, INC.
DSH500008 UNIVERSITY OF WASHINGTON MEDICAL CENTER

Covered Entity Details

Entity Name

UNIVERSITY OF WASHINGTON MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH500008

Entity Address

1959 NE PACIFIC ST.,
SEATTLE, WA 98195

Medicare Provider Number

500008

Participating Start Date

12/1/1992

Last Recertification Date

8/28/2024

Pharmacy Details

Pharmacy Name

OPTION CARE ENTERPRISES, INC.

Pharmacy Address

D/B/A OPTION CARE
13035 GATEWAY DRIVE
SUITE 131
TUKWILA, WA 98168-3395

Pharmacy Comments

Contract Details

Approval Date

4/12/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

MAUREEN BROOM, Enterprise Finance Officer
(206) 598-5362

Contract Pharmacy Representative

UW Medicine
Sumona Patel, Pharmacy Audit and Compliance Manager
(206) 598-6936

Signed By Date

4/12/2017

340B Drug Pricing Program Database