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SCH230239-00 MyMichigan Medical Center Sault (Active)
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Main Details
Name
MyMichigan Medical Center Sault
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230239-00
Medicare Provider Number
230239
Additional Details
Current Program Status
Active
Registration Date
8/19/2010
Participating Start Date
9/1/2010
Participating Approval Date
8/20/2010
Last Recertification Date
8/31/2024
Contacts
Authorizing Official
MyMichigan Medical Center Sault
Kevin Kalchik, President
(906) 635-4456
Primary Contact
MyMichigan Health
Lisa Waibel, 340B Manager
(989) 794-5231
Addresses
Street Address
500 OSBORN BOULEVARD
SAULT STE. MARIE, MI 49783
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/30/10 REMOVED MEDICAID#1776852 AND NPI-1295756948
12/30/2010
May 2025
May 2025
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