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RRC150015-01 FRANCISCAN HEALTH MICHIGAN CITY (Terminated)
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Main Details
Name
FRANCISCAN HEALTH MICHIGAN CITY
Subdivision Name
Woodland Surgery Center
Type
Rural Referral Center
Rural
Yes
340B ID
RRC150015-01
Medicare Provider Number
150015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/5/2019
Last Recertification Date
8/29/2023
Termination Date
Termination Reason
10/1/2024
Change of covered entity type
Contacts
Authorizing Official
Franciscan Alliance
Justin Kats, Division CFO - Crown Point & Michigan City
(219) 757-6403
Primary Contact
Franciscan Health
Laura Shondell, Administrative Director Medication Systems and Operations
(765) 423-6900
Addresses
Street Address
8865 W. 400 N., Suite 100
Michigan City, IN 46360
Billing Address
Franciscan Health Michigan City
3500 Franciscan Way
Michigan City, IN 46360
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2013; Terminated 1/1/2019; Reinstated 10/1/2019.
09/05/2019
April 2025
April 2025
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