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DSH230167L MCLAREN GREATER LANSING (Terminated)
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Main Details
Name
MCLAREN GREATER LANSING
Subdivision Name
Med Onc Group
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230167L
Medicare Provider Number
230167
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/14/2016
Last Recertification Date
9/11/2020
Termination Date
Termination Reason
4/1/2021
Other
Contacts
Authorizing Official
McLaren Greater Lansing
Dale Thompson, Chief Financial Officer
(517) 975-7555
Primary Contact
McLaren Greater Lansing
Marla Ekola, Director of Pharmacy
(517) 975-7942
Addresses
Street Address
2901 Stabler St.
Lansing, MI 48910
Billing Address
McLaren Greater Lansing
401 West Greenlawn Avenue
Lansing, MI 48910
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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