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DSH230089C WILLIAM BEAUMONT HOSPITAL D/B/A Corewell Health Beaumont Grosse Pointe Hospital (Active)
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Main Details
Name
WILLIAM BEAUMONT HOSPITAL D/B/A Corewell Health Beaumont Grosse Pointe Hospital
Subdivision Name
Beaumont Vein Clinic - Grosse Pointe - RADIOLOGY-DIAGNOSTIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230089C
Medicare Provider Number
230089
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/13/2019
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Primary Contact
Corewell Health
Thomas Schaible, Mgr, Pharmacy CHE
(947) 522-1169
Addresses
Street Address
87 Kercheval, Suite 100
Grosse Pointe, MI 48230
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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