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DSH230080AK MCLAREN CENTRAL MICHIGAN (Active)
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Main Details
Name
MCLAREN CENTRAL MICHIGAN
Subdivision Name
RHC - McLaren Central Michigan Infectious Disease
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230080AK
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
560 West Mitchell St
Suite 170
Petoskey, MI 49770
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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