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SCH230093-01 Spectrum Health Big Rapids Hospital (Terminated)
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Main Details
Name
Spectrum Health Big Rapids Hospital
Subdivision Name
Occupation Medicine
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230093-01
Medicare Provider Number
230093
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/4/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/8/2013
Last Recertification Date
9/5/2016
Termination Date
Termination Reason
1/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Spectrum Health
Tom Knoerl, Controller
(231) 592-4253
Primary Contact
Spectrum Health System - Grand Rapids, MI
Ryan Wells Foster, Dir. Pharmacy
(616) 391-3028
Addresses
Street Address
705 Oak Street
Big Rapids, MI 49307
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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