340B Drug Pricing Program Database
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DSH230080AE MCLAREN CENTRAL MICHIGAN (Terminated)
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Main Details
Name
MCLAREN CENTRAL MICHIGAN
Subdivision Name
RHC - Evergreen Clinic - Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH230080AE
Medicare Provider Number
230080
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/10/2022
Last Recertification Date
9/13/2022
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
DSH230080-00
Tara Soules, Chief Financial Officer
(989) 772-6818
Primary Contact
McLaren Health Care
Sharelle Brown, Corporate, 340B Program Director
(248) 396-8085
Addresses
Street Address
611 Court St
West Branch, MI 48661
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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