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DSH230029 TRINITY HEALTH OAKLAND HOSPITAL (Active)
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Main Details
Name
TRINITY HEALTH OAKLAND HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230029
Medicare Provider Number
230029
Additional Details
Current Program Status
Active
Registration Date
6/6/2022
Participating Start Date
7/1/2022
Participating Approval Date
6/10/2022
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Trinity Health Oakland Hospital
Melissa Karolak, Vice President Finance
(734) 655-2825
Primary Contact
Trinity Health
Michele Thatcher, Director, Pharmacy
(734) 655-2651
Addresses
Street Address
44405 WOODWARD AVENUE
PONTIAC, MI 48341
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: 01/01/2020; until terminated effective date: 02/2/2021; reinstatement effective date: 07/01/2022
06/10/2022
Participating from effective date: 01/01/2020; until terminated effective date: 02/21/2021; reinstatement effective date: 07/01/2022
06/10/2022
Participated starting 10/1/2014, terminated 1/1/2019. Reinstated 1/1/2020.
10/24/2019
April 2025
April 2025
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