340B Drug Pricing Program Database
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DSH230059BK SAINT MARY'S HEALTH CARE (Active)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
MHPP OBGYN DTO HUDSONVILLE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059BK
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/15/2019
Last Recertification Date
9/5/2024
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
3925 32nd Avenue, Suite 300
Suite 300
Hudsonville, MI 49426
Billing Address
Mercy Health Saint Mary's
200 Jefferson Avenue SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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