Covered Entity Details

DSH230075J BRONSON BATTLE CREEK HOSPITAL (Active) - information as of 5/14/2025 10:50:44 PM

Main Details

Name

BRONSON BATTLE CREEK HOSPITAL

Subdivision Name

BBC ORTHO NORTH - BRONSON BATTLE CREEK ORTHOPEDIC SPECIALISTS

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH230075J

Medicare Provider Number

230075

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/6/2020

Participating Start Date

7/1/2020

Participating Approval Date

5/8/2020

Last Recertification Date

8/28/2024

Contacts

Authorizing Official

Bronson Healthcare Group
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907

Primary Contact

Bronson Healthcare Group
Troy Shirley, System Director of Pharmacy
(269) 341-8157

Addresses

Street Address

710 NORTH AVE
BATTLE CREEK, MI 49017-3258

Billing Address

BRONSON ACCOUNTS PAYABLE
P.O. BOX 4001
KALAMAZOO, MI 49003

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?
Yes

State	Medicaid Number	NPI Number
MI		1083644579

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
DSH230075A	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON RHEUMATOLOGY SPECIALISTS BATTLE CREEK	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075B	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON INTERNAL MEDICINE BATTLE CREEK	2845 CAPITAL AVE SW	BATTLE CREEK	MI	Active
DSH230075C	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON CRITICAL CARE & PULMONARY	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075D	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON BATTLE CREEK HOSPITAL - Bronson Neuroscience Center Battle Creek	300 NORTH AVE OUTPATIENT CENTER 2ND FLOOR	BATTLE CREEK	MI	Active
DSH230075E	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON FAMILY MEDICINE - HELMER RD - Bronson Fam Med Helmer Road	2900 WATKINS RD	BATTLE CREEK	MI	Active
DSH230075F	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC MED ONC MRSHL - BRONSON BATTLE CREEK HEMATOLOGY & ONCOLOGY	212 WINSTON DR	MARSHALL	MI	Active
DSH230075G	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC DIABETES CENTER - BRONSON BATTLE CREEK DIABETES CENTER	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075H	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC GENERAL SURGERY - BRONSON BATTLE CREEK GENERAL SURGERY	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075J	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC ORTHO NORTH - BRONSON BATTLE CREEK ORTHOPEDIC SPECIALISTS	710 NORTH AVE	BATTLE CREEK	MI	Active
DSH230075K	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC UROLOGY - BRONSON BATTLE CREEK UROLOGY SPECIALISTS	4441 CAPITAL AVE SW	BATTLE CREEK	MI	Active
DSH230075L	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC SLEEP CENTER - BRONSON BATTLE CREEK SLEEP CENTER	5161 B DR S	BATTLE CREEK	MI	Terminated
DSH230075M	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	Bronson Sleep Health Specialists - Battle Creek	2845 Capital Ave SW	BATTLE CREEK	MI	Active
DSH230075N	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON BATTLE CREEK PEDIATRIC CARDIOLOGY	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075P	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	Bronson Cardiothoracic Surgery Specialists - Battle Creek	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075Q	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC OBGYN CAPITAL - BRONSON BATTLE CREEK OB/GYN	3238 CAPITAL AVE SW	BATTLE CREEK	MI	Active
DSH230075R	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC ORTHO MARSHALL - BRONSON BATTLE CREEK ORTHOPEDIC SPECIALISTS	212 WINSTON DR	MARSHALL	MI	Active
DSH230075S	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BMH MATERNAL FETAL MED - BRONSON BATTLE CREEK MATERNAL FETAL MEDICINE	3238 CAPITAL AVE SW	BATTLE CREEK	MI	Active
DSH230075T	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BMH HAND ELBOW HERITG - BRONSON BATTLE CREEK HAND & ELBOW SURGERY	710 North Ave	BATTLE CREEK	MI	Terminated
DSH230075U	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BRONSON SPINE & SCOLIOSIS SPECIALISTS - BATTLE CREEK	2 HERITAGE OAK LN	BATTLE CREEK	MI	Active
DSH230075V	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC ORTHO HERITAGE - BRONSON BATTLE CREEK ORTHOPEDIC SPECIALISTS	2 HERITAGE OAK LN	BATTLE CREEK	MI	Active
DSH230075W	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	Bronson Colon & Rectal Surgery Specialists - Capital Ave	212 WINSTON DR	MARSHALL	MI	Active
DSH230075X	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC VASCULAR SURGERY - BRONSON BATTLE CREEK VASCULAR SURGERY	363 FREMONT ST	BATTLE CREEK	MI	Active
DSH230075Y	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	Bronson Family Medicine - Marshall - Family Medicine	212 Winston Drive	Marshall	MI	Active
DSH230075Z	Child	DSH	BRONSON BATTLE CREEK HOSPITAL	BBC Urgent Care - Urgent Care	2151 W Columbia Ave	Battle Creek	MI	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	NPI: Number	Delete	Group Change Request	1093119638 (MI)		11/12/2024 11:09 AM
Details	Last Recertification Date	Update	Recertification	8/23/2023 7:41:24 AM	8/28/2024 8:59:49 AM	8/28/2024 8:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1083644579	1/24/2024 3:45 PM
Medicaid Billing	NPI: State	Insert	Change Request		MI	1/24/2024 3:45 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1093119638	1/24/2024 3:45 PM
Medicaid Billing	NPI: State	Insert	Change Request		MI	1/24/2024 3:45 PM
Details	Last Recertification Date	Update	Recertification	8/31/2022 9:42:52 AM	8/23/2023 7:41:24 AM	8/23/2023 7:41 AM
Details	Last Recertification Date	Update	Recertification	8/19/2021 9:20:26 AM	8/31/2022 9:42:52 AM	8/31/2022 9:42 AM
Details	Last Recertification Date	Update	Recertification	8/18/2020 2:33:16 PM	8/19/2021 9:20:26 AM	8/19/2021 9:20 AM
Contacts	Primary Contact	Update	Profile Change Request	Shirley, Troy System Director of Pharmacy Bronson Mehtodist Hospital 2693418157	Shirley, Troy System Director of Pharmacy Bronson Healthcare Group 2693418157	12/3/2020 8:26 AM
Details	Last Recertification Date	Update	Recertification		8/18/2020 2:33:16 PM	8/18/2020 2:33 PM
Contacts	Primary Contact	Update	Change Request	Phillips, Shaun Vice President, Clinical and Pharmacy Services Bronson 2692455987	Shirley, Troy System Director of Pharmacy Bronson Mehtodist Hospital 2693418157	8/7/2020 2:59 PM
Details	State	Update		Approved	Active	7/1/2020 12:00 AM
Contacts	Signed By	Insert	New Registration		Falahee Jr., James B. Sr. Vice President, Legal & Legislative Affairs Bronson Healthcare Group 2693418907	5/8/2020 3:27 PM
Details	340B ID	Update	New Registration		DSH230075J	5/8/2020 3:27 PM
Details	Entity Name	Update	New Registration	BRONSON BATTLE CREEK	BRONSON BATTLE CREEK HOSPITAL	5/8/2020 3:27 PM
Details	Entity Subname	Update	New Registration	BBC ORTHO NORTH	BBC ORTHO NORTH - BRONSON BATTLE CREEK ORTHOPEDIC SPECIALISTS	5/8/2020 3:27 PM
Dates	Participating Approval Date	Update	New Registration		5/8/2020 3:27:06 PM	5/8/2020 3:27 PM
Details	State	Update	New Registration	Pending	Approved	5/8/2020 3:27 PM
Dates	Signed By Date	Update	New Registration		4/6/2020 11:22:39 AM	5/8/2020 3:27 PM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	5/8/2020 3:27 PM
Addresses	Main Address	Insert	New Registration		710 NORTH AVE BATTLE CREEK, MI 49017-3258	4/6/2020 10:57 AM
Addresses	Billing Address	Insert	New Registration		BRONSON ACCOUNTS PAYABLE P.O. BOX 4001 KALAMAZOO, MI 49003	4/6/2020 10:57 AM
Contacts	Authorizing Official	Insert	New Registration		Falahee Jr., James B. Sr. Vice President, Legal & Legislative Affairs Bronson Healthcare Group 2693418907	4/6/2020 10:57 AM
Contacts	Primary Contact	Insert	New Registration		Phillips, Shaun Vice President, Clinical and Pharmacy Services Bronson 2692455987	4/6/2020 10:57 AM
Details	Last Recertification Date	Insert	New Registration			4/6/2020 10:57 AM
Details	Grant Number	Insert	New Registration			4/6/2020 10:57 AM
Details	340B ID	Insert	New Registration			4/6/2020 10:57 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/6/2020 10:57 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/6/2020 10:57 AM
Details	Medicare Provider Number	Insert	New Registration		230075	4/6/2020 10:57 AM
Details	Entity Name	Insert	New Registration		BRONSON BATTLE CREEK	4/6/2020 10:57 AM
Details	Program Code	Insert	New Registration		DSH	4/6/2020 10:57 AM
Details	Entity Subname	Insert	New Registration		BBC ORTHO NORTH	4/6/2020 10:57 AM
Dates	Participating Approval Date	Insert	New Registration			4/6/2020 10:57 AM
Details	State	Insert	New Registration		Pending	4/6/2020 10:57 AM
Dates	Registration Date	Insert	New Registration		4/6/2020 10:57:06 AM	4/6/2020 10:57 AM
Dates	Signed By Date	Insert	New Registration			4/6/2020 10:57 AM
Dates	Start Date	Insert	New Registration			4/6/2020 10:57 AM
Terminations	Termination Comments	Insert	New Registration			4/6/2020 10:57 AM
Terminations	Termination Date	Insert	New Registration			4/6/2020 10:57 AM
Terminations	Termination Effective Date	Insert	New Registration			4/6/2020 10:57 AM
Terminations	Termination Reason	Insert	New Registration			4/6/2020 10:57 AM