340B Drug Pricing Program Database
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DSH230059BB SAINT MARY'S HEALTH CARE (Terminated)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
MHPP Lacks Gyn/Onc - Holland North - GYN ONC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059BB
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/25/2018
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 Wellness Drive, Suite 220
Holland, MI 49424-7261
Billing Address
Saint Mary's Health Care
200 Jefferson Ave SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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