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CH05029D MidMichigan Health Services (Active)
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Main Details
Name
MidMichigan Health Services
Subdivision Name
MidMichigan Medical Offices-Beaverton
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011682
340B ID
CH05029D
Grant Number
H80CS00190
Additional Details
Current Program Status
Active
Registration Date
10/15/2012
Participating Start Date
1/1/2013
Participating Approval Date
11/16/2012
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
MidMichigan Community Health Services
Melissa Jean Dunkle, CEO
(989) 422-2105 Ext: 2105
Primary Contact
MidMichigan Community Health Services
Bill Collin, Chief Financial Officer
(989) 202-4604
Addresses
Street Address
439 S Ross Street
Beaverton, MI 48612-9101
Billing Address
MidMichigan Health Services
9249 West Lake City Road
HOUGHTON LAKE, MI 48629
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/6/12 - Reviewed registration and forwarded to IS for approval.
11/06/2012
April 2025
April 2025
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