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DSH230021W LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS (Active)
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Main Details
Name
LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS
Subdivision Name
LAKELAND CENTER FOR WOUND CARE AND
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230021W
Medicare Provider Number
230021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/5/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/26/2017
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Primary Contact
Lakeland Regional Health DBA Corewell Health
Nicole Weston, Business Analyst
(269) 985-4431
Addresses
Street Address
42 N SAINT JOSEPH AVE
suite 103
NILES, MI 49120
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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