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DSH230080D MCLAREN CENTRAL MICHIGAN (ToBeTerminated)
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Main Details
Name
MCLAREN CENTRAL MICHIGAN
Subdivision Name
RHC - McLaren Central Michigan Primary Care Mio
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230080D
Medicare Provider Number
230080
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
7/15/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/27/2021
Last Recertification Date
8/26/2024
Termination Date
Termination Reason
7/1/2025
Site closure
Contacts
Authorizing Official
DSH230080-00
Tara Soules, Chief Financial Officer
(989) 772-6818
Primary Contact
McLaren Health Care
Tiffany Harwood, Corporate Director of 340B Data Analytics
(734) 512-8778
Addresses
Street Address
558 Lockwood Lane
Mio, MI 48647
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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