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DSH230130H WILLIAM BEAUMONT HOSPITAL- ROYAL OAK (Terminated)
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Main Details
Name
WILLIAM BEAUMONT HOSPITAL- ROYAL OAK
Subdivision Name
BEAUMONT ASSOCIATES VAS & ENDO SURG - Vascular Services
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230130H
Medicare Provider Number
230130
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/5/2024
Last Recertification Date
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Primary Contact
Corewell Health
Thomas Schaible, Mgr, Pharmacy CHE
(947) 522-1169
Addresses
Street Address
4600 INVESTMENT DR
STE 250
TROY, MI 48098-6370
Billing Address
WILLIAM BEAUMONT HOSPITAL dba Beaumont Hospital - Royal Oak
3601 WEST 13 MILE ROAD
ROYAL OAK, MI 48073
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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