340B Drug Pricing Program Database
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DSH230059CC SAINT MARY'S HEALTH CARE (Active)
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Main Details
Name
SAINT MARY'S HEALTH CARE
Subdivision Name
Mercy Health Internal Medicine Private Practice - Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230059CC
Medicare Provider Number
230059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/20/2021
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Trinity Health Muskegon Hospital
Daniel G. Green, Vice President for Finance
(616) 685-6709
Primary Contact
Saint Mary's Health Care
Robert D Bird, 340B Program Manager
(616) 685-1107
Addresses
Street Address
300 Lafayette SE, Suite 3000
Grand Rapids, MI 49503
Billing Address
Mercy Health Saint Mary's
200 Jefferson Ave SE
Grand Rapids, MI 49503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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