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DSH230059 SAINT MARY'S HEALTH CARE (Active)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059
Medicare Provider Number
230059
Additional Details
Current Program Status
Active
Registration Date
12/1/2005
Participating Start Date
12/1/2005
Participating Approval Date
12/1/2005
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Trinity Health Muskegon Hospital
Daniel G. Green, Vice President for Finance
(616) 685-6709
Primary Contact
Saint Mary's Health Care
Robert D Bird, 340B Program Manager
(616) 685-1107
Addresses
Street Address
200 JEFFERSON SE
GRAND RAPIDS, MI 49503
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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02/29/2012 removed medicaid # (was 5172062 MI); 8/25/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %; PARTICIPATED AS DSH495031 FROM 4/1/05-9/30/05, INELIGIBLE 10/1/05-11/30/05
02/29/2012
8/25/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %; PARTICIPATED AS DSH495031 FROM 4/1/05-9/30/05, INELIGIBLE 10/1/05-11/30/05
10/20/2009
May 2025
May 2025
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