340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH230021D LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH (Terminated)
Print
Main Details
Name
LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH
Subdivision Name
LAKELAND HOMECARE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230021D
Medicare Provider Number
230021
Outpatient Facility Provider Number
237163
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/4/2019
Last Recertification Date
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Spectrum Health
Paul Vincent Konopacki, VP Finance & CFO
(269) 313-7188 Ext: 2693137188
Primary Contact
Lakeland Health
MICHAEL J. TAYLOR, 340B COORDINATOR
(269) 687-1877
Addresses
Street Address
2550 MEADOWBROOK RD
STE 110
BENTON HARBOR, MI 49022-9609
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Participating start date 10/1/2014; Terminated 4/1/2017; Reinstated 10/1 2019.
07/09/2019
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session