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DSH230021C LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS (Terminated)
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Main Details
Name
LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS
Subdivision Name
LAKELAND ONCOLOGY CLINIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230021C
Medicare Provider Number
230021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/9/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/14/2011
Last Recertification Date
8/20/2024
Termination Date
Termination Reason
1/1/2025
Business decision by the Covered Entity
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
3900 HOLLYWOOD ROAD
ST JOSEPH, MI 49085
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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