Covered Entity Details

DSH230217T Oaklawn Hospital (Terminated) - information as of 5/29/2025 1:52:58 AM

Main Details

Name

Oaklawn Hospital

Subdivision Name

OMG Pain Management

Type

Disproportionate Share Hospital

Rural

340B ID

DSH230217T

Medicare Provider Number

230217

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/3/2018

Participating Start Date

10/1/2018

Participating Approval Date

7/5/2018

Last Recertification Date

8/30/2022

Termination Date
Termination Reason

7/1/2023
Business decision by the Covered Entity

Contacts

Authorizing Official

Oaklawn Hospital
Andrew James Poole, CFO
(269) 789-3936

Primary Contact

Oaklawn Hospital
Nicole L. Patrick, Pharmacy Informatics Coordinator
(269) 789-7482

Addresses

Street Address

200 N Madison St
Marshall, MI 49068

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH230217AA	Child	DSH	Oaklawn Hospital	Oaklawn Psychological Services - Psychological	15209 W Michigan Ave	Marshall	MI	Active
DSH230217AB	Child	DSH	Oaklawn Hospital	OMG MICHIGAN AVENUE PRIMARY CARE - Primary Care	1174 W MICHIGAN AVE	MARSHALL	MI	Active
DSH230217AC	Child	DSH	Oaklawn Hospital	OMG OBSTETRICS AND GYNECOLOGY - OBSTETRICS AND GYNECOLOGY	215 E Mansion St	Marshall	MI	Active
DSH230217AD	Child	DSH	Oaklawn Hospital	OAKLAWN MEDICAL GROUP COLDWATER - Family Practice	375 N WILLOWBROOK RD	COLDWATER	MI	Active
DSH230217AE	Child	DSH	Oaklawn Hospital	OAKLAWN EXPRESS CARE - BECKLEY ROAD - Express Care	5352 BECKLEY RD	BATTLE CREEK	MI	Active
DSH230217AF	Child	DSH	Oaklawn Hospital	OMG WRIGHT MEDICAL PRIMARY CARE - Primary Care	215 E MANSION ST	MARSHALL	MI	Active
DSH230217D	Child	DSH	Oaklawn Hospital	Oaklawn Hematology/Oncology Clinic	215 East Mansion Street	Marshall	MI	Active
DSH230217E	Child	DSH	Oaklawn Hospital	OMG GENERAL SURGERY - General Surgery	215 E MANSION ST	MARSHALL	MI	Active
DSH230217F	Child	DSH	Oaklawn Hospital	OMG MIFM - Internal/Family Medicine	720 US HIGHWAY 27 N	MARSHALL	MI	Active
DSH230217G	Child	DSH	Oaklawn Hospital	OMG BEADLE LAKE - Family Practice	14231 BEADLE LAKE RD	BATTLE CREEK	MI	Active
DSH230217H	Child	DSH	Oaklawn Hospital	OMG OB SUITE - Family Practice/Obstetrics	215 E MANSION ST	MARSHALL	MI	Terminated
DSH230217J	Child	DSH	Oaklawn Hospital	OMG HEART AND VASCULAR - Cardiovascular	215 E MANSION ST	MARSHALL	MI	Active
DSH230217K	Child	DSH	Oaklawn Hospital	Oaklawn Express Care - Marshall	1174 W Michigan Ave	MARSHALL	MI	Active
DSH230217L	Child	DSH	Oaklawn Hospital	OMG OLIVET - Family Practice	202 N MAIN ST	OLIVET	MI	Active
DSH230217M	Child	DSH	Oaklawn Hospital	OMG ENT - Ear, Nose, Throat	215 E MANSION ST	MARSHALL	MI	Active
DSH230217N	Child	DSH	Oaklawn Hospital	OMG TEKONSHA - Family Practice	2218 US HIGHWAY 27 N	TEKONSHA	MI	Active
DSH230217P	Child	DSH	Oaklawn Hospital	OMG GASTROENTEROLOGY - Gastroenterology	215 E MANSION ST	MARSHALL	MI	Active
DSH230217Q	Child	DSH	Oaklawn Hospital	OMG ALBION - Family Practice	302 N Monroe St Ste A	ALBION	MI	Active
DSH230217R	Child	DSH	Oaklawn Hospital	OMG PULMONOLOGY - Pulmonology	103 E MANSION ST	MARSHALL	MI	Active
DSH230217S	Child	DSH	Oaklawn Hospital	OAKLAWN WOUND CARE CENTER - Wound Care	13697 15 MILE RD	MARSHALL	MI	Active
DSH230217T	Child	DSH	Oaklawn Hospital	OMG Pain Management	200 N Madison St	Marshall	MI	Terminated
DSH230217U	Child	DSH	Oaklawn Hospital	OMG MARSHALL PRIMARY CARE - Internal/Family Medicine	215 E MANSION ST	MARSHALL	MI	Active
DSH230217V	Child	DSH	Oaklawn Hospital	OMG Endocrinology	215 E Mansion St	MARSHALL	MI	Active
DSH230217W	Child	DSH	Oaklawn Hospital	OMG Allergy, Asthma, and Immunology	111 S Hamilton	MARSHALL	MI	Active
DSH230217X	Child	DSH	Oaklawn Hospital	OMG Rheumatology	215 E Mansion St	Marshall	MI	Active
DSH230217Y	Child	DSH	Oaklawn Hospital	OMG MARSHALL SPECIALTY CLINIC - OMG Orthopedic Clinic	203 WINSTON DR	MARSHALL	MI	Active
DSH230217Z	Child	DSH	Oaklawn Hospital	Oaklawn Express Care - Albion	302 N MONROE ST	ALBION	MI	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	7/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		5/25/2023 12:00:00 AM	6/22/2023 9:35 AM
Details	State	Update	Termination Request	Active	To Be Terminated	6/22/2023 9:35 AM
Terminations	Termination Date	Update	Termination Request		7/1/2023 12:00:00 AM	6/22/2023 9:35 AM
Terminations	Termination Effective Date	Update	Termination Request		5/26/2023 12:00:00 AM	6/22/2023 9:35 AM
Terminations	Termination Reason	Update	Termination Request		Business decision by the Covered Entity	6/22/2023 9:35 AM
Addresses	Main Address	Update	Change Request	215 E Mansion St 2C Marshall, MI 49068-1559	200 N Madison St Marshall, MI 49068	12/21/2022 4:23 PM
Addresses	Shipping Address	Delete	Change Request	Oaklawn Hospital 200 N Madison St Marshall, MI 49068-1143		12/21/2022 4:23 PM
Details	Last Recertification Date	Update	Recertification	8/17/2021 1:59:39 PM	8/30/2022 2:46:02 PM	8/30/2022 2:46 PM
Details	Last Recertification Date	Update	Recertification	8/27/2020 3:18:20 PM	8/17/2021 1:59:39 PM	8/17/2021 1:59 PM
Details	Entity Subname	Update	Change Request	Pain Clinic - Pain Clinic	OMG Pain Management	7/16/2021 11:37 AM
Details	Last Recertification Date	Update	Recertification	8/23/2019 9:08:09 AM	8/27/2020 3:18:20 PM	8/27/2020 3:18 PM
Addresses	Main Address	Update	Change Request	215 E Mansion St 3C Marshall, MI 49068-1559	215 E Mansion St 2C Marshall, MI 49068-1559	4/27/2020 12:44 PM
Details	Last Recertification Date	Update	Recertification		8/23/2019 9:08:09 AM	8/23/2019 9:08 AM
Contacts	Authorizing Official	Update	Change Request	Beeg, Gregg M. Interim President and CEO Oaklawn Hospital 2697893924	Poole, Andrew James CFO Oaklawn Hospital 2697893936	3/12/2019 9:50 AM
Contacts	Authorizing Official	Update	Profile Change Request	Beeg, Gregg M. Chief Financial Officer Oaklawn Hospital 2697893921	Beeg, Gregg M. Interim President and CEO Oaklawn Hospital 2697893924	10/16/2018 11:41 AM
Contacts	Signed By	Update	Profile Change Request	Beeg, Gregg M. Chief Financial Officer Oaklawn Hospital 2697893921	Beeg, Gregg M. Interim President and CEO Oaklawn Hospital 2697893924	10/16/2018 11:41 AM
Contacts	Primary Contact	Update	Profile Change Request	Patrick, Nicole L. Pharmacy Informatics Coordinator Oaklawn Hospital 2697893905-2135	Patrick, Nicole L. Pharmacy Informatics Coordinator Oaklawn Hospital 2697897482	10/16/2018 8:24 AM
Details	State	Update		Approved	Active	10/1/2018 12:05 AM
Contacts	Signed By	Insert	New Registration		Beeg, Gregg M. Chief Financial Officer Oaklawn Hospital 2697893921	7/5/2018 2:20 PM
Details	340B ID	Update	New Registration		DSH230217T	7/5/2018 2:20 PM
Details	Entity Subname	Update	New Registration	Pain Clinic	Pain Clinic - Pain Clinic	7/5/2018 2:20 PM
Dates	Participating Approval Date	Update	New Registration		7/5/2018 2:20:45 PM	7/5/2018 2:20 PM
Details	State	Update	New Registration	Pending	Approved	7/5/2018 2:20 PM
Dates	Signed By Date	Update	New Registration		7/3/2018 10:59:58 AM	7/5/2018 2:20 PM
Dates	Start Date	Update	New Registration		10/1/2018 12:00:00 AM	7/5/2018 2:20 PM
Addresses	Main Address	Insert	New Registration		215 E Mansion St 3C Marshall, MI 49068-1559	7/3/2018 10:59 AM
Addresses	Billing Address	Insert	New Registration		Oaklawn Hospital 200 N Madison St Marshall, MI 49068-1143	7/3/2018 10:59 AM
Addresses	Shipping Address	Insert	New Registration		Oaklawn Hospital 200 N Madison St Marshall, MI 49068-1143	7/3/2018 10:59 AM
Contacts	Authorizing Official	Insert	New Registration		Beeg, Gregg M. Chief Financial Officer Oaklawn Hospital 2697893921	7/3/2018 10:59 AM
Contacts	Primary Contact	Insert	New Registration		Patrick, Nicole L. Pharmacy Informatics Coordinator Oaklawn Hospital 2697893905-2135	7/3/2018 10:59 AM
Details	Last Recertification Date	Insert	New Registration			7/3/2018 10:59 AM
Details	Grant Number	Insert	New Registration			7/3/2018 10:59 AM
Details	340B ID	Insert	New Registration			7/3/2018 10:59 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/3/2018 10:59 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/3/2018 10:59 AM
Details	Medicare Provider Number	Insert	New Registration		230217	7/3/2018 10:59 AM
Details	Entity Name	Insert	New Registration		Oaklawn Hospital	7/3/2018 10:59 AM
Details	Program Code	Insert	New Registration		DSH	7/3/2018 10:59 AM
Details	Entity Subname	Insert	New Registration		Pain Clinic	7/3/2018 10:59 AM
Dates	Participating Approval Date	Insert	New Registration			7/3/2018 10:59 AM
Details	State	Insert	New Registration		Pending	7/3/2018 10:59 AM
Dates	Registration Date	Insert	New Registration		7/3/2018 10:59:55 AM	7/3/2018 10:59 AM
Dates	Signed By Date	Insert	New Registration			7/3/2018 10:59 AM
Dates	Start Date	Insert	New Registration			7/3/2018 10:59 AM
Terminations	Termination Comments	Insert	New Registration			7/3/2018 10:59 AM
Terminations	Termination Date	Insert	New Registration			7/3/2018 10:59 AM
Terminations	Termination Effective Date	Insert	New Registration			7/3/2018 10:59 AM
Terminations	Termination Reason	Insert	New Registration			7/3/2018 10:59 AM