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DSH230038S Corewell Health Grand Rapids Hospitals Butterworth Hospital (Active)
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Main Details
Name
Corewell Health Grand Rapids Hospitals Butterworth Hospital
Subdivision Name
Spectrum Health Blodgett Campus - Electrocardiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230038S
Medicare Provider Number
230038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/7/2024
Participating Start Date
1/1/2025
Participating Approval Date
12/11/2024
Last Recertification Date
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Primary Contact
Corewell Health
Lacey Alviar, Business Intell Analyst, Sr
(616) 391-1179
Addresses
Street Address
1840 Wealthy SE
GRAND RAPIDS, MI 49506
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date - 7/1/2014 Termination Date - 4/1/2023 Reinstatement Date - 1/1/2025
12/11/2024
Registration Date - 4/15/2014 Termination Date - 4/1/2023 Reinstatement Date - 1/1/2025
12/09/2024
April 2025
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