340B Drug Pricing Program Database
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DSH230059AK SAINT MARY'S HEALTH CARE (Active)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
MHPP Epilepsy Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059AK
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/8/2014
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
245 Cherry St, Suite 104
Grand Rapids, MI 49503
Billing Address
Mercy Health Saint Mary's
200 Jefferson Ave SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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