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RRC230227-24 MCLAREN MACOMB (Terminated)
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Main Details
Name
MCLAREN MACOMB
Subdivision Name
Diagnostic Imagine, Therapy and Lab Draw Station - Bay River - ULTRASOUND-BAY RIVER
Type
Rural Referral Center
Rural
Yes
340B ID
RRC230227-24
Medicare Provider Number
230227
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/2/2020
Participating Start Date
12/1/2020
Participating Approval Date
11/13/2020
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
4/1/2024
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
McLaren Macomb
Steve Snyder, Chief Financial Officer
(586) 493-3044
Primary Contact
McLaren Health Care
Tiffany Harwood, Corporate Director of 340B Data Analytics
(734) 512-8778
Addresses
Street Address
36267 26 Mile Suite 2
Lenox, MI 48048
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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