340B Drug Pricing Program Database
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CAH231325-00 MyMichigan Medical Center Gladwin (Active)
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Main Details
Name
MyMichigan Medical Center Gladwin
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH231325-00
Medicare Provider Number
231325
Additional Details
Current Program Status
Active
Registration Date
8/18/2010
Participating Start Date
8/31/2010
Participating Approval Date
8/18/2010
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
MidMichigan Medical Center Gladwin
Ray Stover, Regional President
(989) 246-6203
Primary Contact
MyMichigan Health
Lisa Waibel, 340B Manager
(989) 794-5231
Addresses
Street Address
515 QUARTER STREET
GLADWIN, MI 48624
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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