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DSH230038AE Corewell Health Grand Rapids Hospitals Butterworth Hospital (Active)
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Main Details
Name
Corewell Health Grand Rapids Hospitals Butterworth Hospital
Subdivision Name
Sleep Disorder Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230038AE
Medicare Provider Number
230038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/15/2015
Last Recertification Date
8/20/2024
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
4100 LAKE DRIVE SE
GRAND RAPIDS, MI 49546-8292
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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