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DSH230059A SAINT MARY'S HEALTH CARE (Active)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
Mercy Health Saint Mary's Kidney Transplant Program
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059A
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/7/2013
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Trinity Health Muskegon Hospital
Daniel G. Green, Vice President for Finance
(616) 685-6709
Primary Contact
Saint Mary's Health Care
Robert D Bird, 340B Program Manager
(616) 685-1107
Addresses
Street Address
310 Lafayette Ave SE, Suite 315
Grand Rapids, MI 49503
Billing Address
Saint Mary's Health Care
200 Jefferson Avenue SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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