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DSH230021AV LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS (Approved)
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Main Details
Name
LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS
Subdivision Name
COREWELL HEALTH LAKELAND HOSPITALS - Gastroenterology Practice
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230021AV
Medicare Provider Number
230021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/14/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/14/2025
Last Recertification Date
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Primary Contact
Lakeland Regional Health DBA Corewell Health
Nicole Weston, Business Analyst
(269) 985-4431
Addresses
Street Address
3903 HOLLYWOOD RD
ST. JOSEPH, MI 49085-9149
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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