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DSH230207AA McLaren Oakland (Terminated)
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Main Details
Name
McLaren Oakland
Subdivision Name
McLaren Oakland Baldwin Family Medicine (Residency Clinic)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230207AA
Medicare Provider Number
230207
Outpatient Facility Provider Number
230207
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
8/16/2016
Termination Date
Termination Reason
1/1/2018
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
McLaren Oakland
Lynn Marcotte, CFO
(248) 338-5691
Primary Contact
McLaren Health Care
Sharelle Brown, Corporate, 340B Program Director
(248) 396-8085
Addresses
Street Address
1701 Baldwin Avenue
Suite 203
Pontiac, MI 48340
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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