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CAH231332-00 BRONSON LAKEVIEW HOSPITAL (Active)
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Main Details
Name
BRONSON LAKEVIEW HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH231332-00
Medicare Provider Number
231332
Additional Details
Current Program Status
Active
Registration Date
9/24/2010
Participating Start Date
4/1/2011
Participating Approval Date
3/1/2011
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Bronson Healthcare Group
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907
Primary Contact
Bronson Healthcare Group
Troy Shirley, System Director of Pharmacy
(269) 341-8157
Addresses
Street Address
408 HAZEN STREET
PAW PAW, MI 49079
Billing Address
Bronson Accounts Payable
P.O.Box 4001
Kalamazoo, MI 49003-4001
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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