340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SCH230058-15 MUNSON HEALTHCARE GRAYLING HOSPITAL (Active)
Print
Main Details
Name
MUNSON HEALTHCARE GRAYLING HOSPITAL
Subdivision Name
MUNSON HEALTHCARE GRAYLING - Mio Primary Care - Primary Care
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230058-15
Medicare Provider Number
230058
Outpatient Facility Provider Number
238726
Additional Details
Current Program Status
Active
Registration Date
1/15/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/7/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Munson Healthcare
Kathleen M LaRaia, Vice President
(231) 392-8410
Primary Contact
Munson Healthcare
Sam Patrick Niemi, System Director Reimbursement
(231) 935-7761
Addresses
Street Address
1321 S MOUNT TOM RD
MIO, MI 48647
Billing Address
Munson Healthcare Grayling Hospital
PO Box 669
Traverse City, MI 49685-0669
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session