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DSH230080AS MCLAREN CENTRAL MICHIGAN (Active)
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Main Details
Name
MCLAREN CENTRAL MICHIGAN
Subdivision Name
RHC - McLaren Central Michigan Family Medicine Petoskey
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230080AS
Medicare Provider Number
230080
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/10/2022
Last Recertification Date
8/26/2024
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
820 Arlington Ave
Suite 258
Petoskey, MI 49770
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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