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DSH230059AS SAINT MARY'S HEALTH CARE (Terminated)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
MHPP Holland North
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059AS
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/3/2017
Last Recertification Date
9/5/2024
Termination Date
Termination Reason
1/1/2025
Site closure
Contacts
Authorizing Official
Trinity Health Muskegon Hospital
Daniel G. Green, Vice President for Finance
(616) 685-6709
Primary Contact
Saint Mary's Health Care
Robert D Bird, 340B Program Manager
(616) 685-1107
Addresses
Street Address
3290 North Wellnes Drive
Building D, Suite 220
Holland, MI 49424
Billing Address
Saint Mary's Health Care
200 Jefferson SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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