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RRC230216-00 MCLAREN PORT HURON (Active)
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Main Details
Name
MCLAREN PORT HURON
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC230216-00
Medicare Provider Number
230216
Additional Details
Current Program Status
Active
Registration Date
12/1/2021
Participating Start Date
12/7/2021
Participating Approval Date
12/7/2021
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
McLaren Port Huron
Kyle Vining, McLaren Port Huron CFO
(810) 989-3749
Primary Contact
McLaren Health Care
Tiffany Harwood, Corporate Director of 340B Data Analytics
(734) 512-8778
Addresses
Street Address
1221 PINE GROVE AVENUE
PORT HURON, MI 48060
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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