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DSH230236Q METROPOLITAN HOSPITAL (Terminated)
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Main Details
Name
METROPOLITAN HOSPITAL
Subdivision Name
HEALTH PARK / Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230236Q
Medicare Provider Number
230236
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/16/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/11/2017
Last Recertification Date
9/10/2020
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
Metro Health Hospital
Kris Kurtz, CFO
(616) 252-4844
Primary Contact
Metro Health Hospital
Peter Joseph Haverkamp, Director of Pharmacy Services
(616) 252-7216
Addresses
Street Address
2215 44th Street SW
WYOMING, MI 49519-9691
Billing Address
Metro Health - Accounts Payable
PO BOX 911
Wyoming, MI 49509-0911
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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