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DSH230118 HURON MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
HURON MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230118
Medicare Provider Number
230118
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/6/2016
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
7/1/2021
Other
Contacts
Authorizing Official
McLaren Thumb
Michael E Johnston, CEO/President
(989) 803-7127
Primary Contact
McLaren Thumb Region
Susheel Vij, Director Of Pharmacy
(248) 635-4728
Addresses
Street Address
1100 SOUTH VAN DYKE
BAD AXE, MI 48413
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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