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SCH230222-08 MIDMICHIGAN MEDICAL CTR (Terminated)
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Main Details
Name
MIDMICHIGAN MEDICAL CTR
Subdivision Name
MIDMICHIGAN CNTR MIDLAND - Orthopaedic - Wackerly
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH230222-08
Medicare Provider Number
230222
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/14/2020
Last Recertification Date
8/17/2020
Termination Date
Termination Reason
4/1/2021
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
MidMichigan Health
Bryan Rex Cross, President
(989) 839-1322
Primary Contact
MidMichigan Medical Center - Gratiot
Eileen Constantine, 340B Program Coordinator
(989) 466-7258
Addresses
Street Address
7101 W WACKERLY ST
MIDLAND, MI 48640-7409
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Correction: Reinstated 7/1/2020.
04/13/2020
Participating start date1/1/2018. Terminated 10/1/2018. Reinstated 7/1/2019.
04/13/2020
May 2025
May 2025
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