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DSH230046AT UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS (Terminated)
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Main Details
Name
UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
Subdivision Name
Livonia Specialty Care - Michigan Hearing
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230046AT
Medicare Provider Number
230046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/29/2014
Last Recertification Date
9/12/2019
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
University Of Michigan Hospitals and Health Centers
Jeffrey S. Desmond, Chief Medical Officer
(734) 936-5814
Primary Contact
UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTER
Rachel G Cortis, Associate Chief Operating Officer
(734) 232-1590
Addresses
Street Address
19900 Haggerty Rd
Suite 111
Livonia, MI 48152
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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