340B Drug Pricing Program Database
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DSH230072BA HOLLAND HOSPITAL (Terminated)
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Main Details
Name
HOLLAND HOSPITAL
Subdivision Name
LHP-Women's Health Douglas
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230072BA
Medicare Provider Number
230072
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/5/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/22/2016
Last Recertification Date
9/11/2020
Termination Date
Termination Reason
1/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Holland Hospital
TERRY L. STEELE, CFO
(616) 392-5141
Primary Contact
Holland Hospital
Carol Fletcher, Sr. Director Revenue Integrity
(616) 394-3227
Addresses
Street Address
415 Wiley Road
Suite 102
Douglas, MI 49406
Billing Address
LHP-Women's Health Douglas
Dept 77635
PO Box 77000
Detroit, MI 48277-0635
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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