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SCH230055-00 Marshfield Medical Center - Dickinson (ToBeTerminated)
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Main Details
Name
Marshfield Medical Center - Dickinson
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230055-00
Medicare Provider Number
230055
Additional Details
Current Program Status
ToBeTerminated
Registration Date
8/26/2011
Participating Start Date
7/1/2017
Participating Approval Date
9/19/2011
Last Recertification Date
8/30/2024
Termination Date
Termination Reason
7/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Marshfield Clinic Health System
Jeffrey Poppen, CFO
(715) 387-5119
Primary Contact
Marshfield Clinic Health System
Christina Kellar, Director - 340B
(262) 328-7086
Addresses
Street Address
1721 S. Stephenson Avenue
Iron Mountain, MI 49801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2011, terminated 10/1/2016, Reinstated 7/1/2017;
06/09/2017
June 2025
June 2025
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