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CAH231322-01 MUNSON HEALTHCARE CHARLEVOIX HOSPITAL (Terminated)
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Main Details
Name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Subdivision Name
MUNSON HEALTHCARE / Boyne Rehab Center
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH231322-01
Medicare Provider Number
231322
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/5/2014
Last Recertification Date
8/19/2020
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
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
197 STATE STREET
BOYNE CITY, MI 49712-1288
Billing Address
Munson Healthcare Charlevoix Hospital
14700 Lake Shore Dr.
Charlevoix, MI 49720
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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