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RRC230141-06 MCLAREN FLINT (Terminated)
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Main Details
Name
MCLAREN FLINT
Subdivision Name
Kamanos Cancer Institute-Lapeer Radiation - Radiation Oncology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC230141-06
Medicare Provider Number
230141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/18/2020
Participating Start Date
12/22/2020
Participating Approval Date
12/22/2020
Last Recertification Date
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
McLaren Flint
FRED KORTE, CFO
(248) 338-5691
Primary Contact
McLaren Flint
Kellie Renee Vandeusen, Regional Director of Reimbursement
(810) 342-2876
Addresses
Street Address
1295 Barry Dr
Suite A
Lapeer, MI 48446
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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