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DSH230099B MONROE REGIONAL HOSPITAL (Approved)
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Main Details
Name
MONROE REGIONAL HOSPITAL
Subdivision Name
Gastroenterology Clinic - Gastroenterology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230099B
Medicare Provider Number
230099
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/10/2025
Last Recertification Date
Contacts
Authorizing Official
ProMedica Monroe Regional Hospital
Joseph Raj Jr., Director Finance
(734) 240-4524
Primary Contact
Promedica Health Systems
Devan Matthew Ribley, Lead 340B Analyst
(567) 585-0154
Addresses
Street Address
1066 N MONROE ST
Monroe, MI 48162
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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