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SCH230222-42 MYMICHIGAN MEDICAL CENTER MIDLAND (Terminated)
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Main Details
Name
MYMICHIGAN MEDICAL CENTER MIDLAND
Subdivision Name
SPINE & PAIN PROGRAM - Pain Management
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230222-42
Medicare Provider Number
230222
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2024
Participating Start Date
4/1/2024
Participating Approval Date
3/4/2024
Last Recertification Date
8/19/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
MyMichigan Medical Center Midland
Chuck Sherwin, President
(989) 794-7625
Primary Contact
MyMichigan Health
Lisa Waibel, 340B Manager
(989) 794-5231
Addresses
Street Address
555 W WACKERLY ST
STE 3625
MIDLAND, MI 48640-4715
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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