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DSH230017AR BRONSON METHODIST HOSPITAL (Active)
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Main Details
Name
BRONSON METHODIST HOSPITAL
Subdivision Name
BMH PEDS GI - BRONSON PEDIATRIC GASTROENTEROLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230017AR
Medicare Provider Number
230017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/6/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/29/2020
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Bronson Healthcare Group
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907
Primary Contact
Bronson Healthcare Group
Troy Shirley, System Director of Pharmacy
(269) 341-8157
Addresses
Street Address
601 JOHN ST
M-351
KALAMAZOO, MI 49007-5344
Billing Address
BRONSON ACCOUNTS PAYABLE
P.O. BOX 4001
KALAMAZOO, MI 49003
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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