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DSH230072A HOLLAND HOSPITAL (Terminated)
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Main Details
Name
HOLLAND HOSPITAL
Subdivision Name
Douglas Outpatient Rehab Lab Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230072A
Medicare Provider Number
230072
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/29/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/19/2011
Last Recertification Date
8/5/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
Holland Hospital
TERRY L. STEELE, CFO
(616) 392-5141
Primary Contact
Holland Hospital
Carol Fletcher, Sr. Director Revenue Integrity
(616) 394-3227
Addresses
Street Address
2993 Blue Star Highway
Suite 101
Douglas, MI 49406
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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