340B Drug Pricing Program Database
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DSH230066CC Trinity Health Muskegon Hospital (Terminated)
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Main Details
Name
Trinity Health Muskegon Hospital
Subdivision Name
Trinity Health Medical Group, Primary Care - Quarterline
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230066CC
Medicare Provider Number
230066
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/12/2020
Last Recertification Date
9/9/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
Trinity Health Muskegon Hospital
Daniel G. Green, Vice President for Finance
(616) 685-6709
Primary Contact
Trinity Health Muskegon Hospital
Scott Butler, Pharmaceutical Assistance/340B Program Coordinator
(231) 215-4459
Addresses
Street Address
221 S Quarterline Rd.
Ste. 100
Muskegon, MI 49442
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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