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DSH230217AB Oaklawn Hospital (Active)
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Main Details
Name
Oaklawn Hospital
Subdivision Name
OMG MICHIGAN AVENUE PRIMARY CARE - Primary Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230217AB
Medicare Provider Number
230217
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/7/2020
Participating Start Date
10/1/2020
Participating Approval Date
8/12/2020
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Oaklawn Hospital
Andrew James Poole, CFO
(269) 789-3936
Primary Contact
Oaklawn Hospital
Nicole L. Patrick, Pharmacy Informatics Coordinator
(269) 789-7482
Addresses
Street Address
1174 W MICHIGAN AVE
STE A
MARSHALL, MI 49068-1497
Billing Address
Oaklawn Hospital
200 North Madison St
Marshall, MI 49068
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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