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SCH230081-02 Munson Healthcare Cadillac Hospital (Terminated)
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Main Details
Name
Munson Healthcare Cadillac Hospital
Subdivision Name
McBain Family Practice
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230081-02
Medicare Provider Number
230081
Outpatient Facility Provider Number
230081
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/16/2014
Last Recertification Date
12/1/2017
Termination Date
Termination Reason
7/1/2018
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Munson Healthcare
Mark Hepler, CFO
(231) 935-6702
Primary Contact
Munson Healthcare
Steve Leach, Regional Director, Reimbursement
(231) 935-7797
Addresses
Street Address
100 N ROLAND ST
MERCY CADILLAC PHYSICAN NETWORK
MCBAIN, MI 49657-9683
Billing Address
Munson Healthcare Cadillac Hospital
PO Box 669
Traverse City, MI 49685
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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