340B Drug Pricing Program Database
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DSH230036F MyMichigan Medical Center Alpena (Active)
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Main Details
Name
MyMichigan Medical Center Alpena
Subdivision Name
MIDMICHIGAN MEDICAL CENTER - ALPENA - Urgent Care- Alpena
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230036F
Medicare Provider Number
230036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/4/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/7/2022
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
MyMichigan Medical Center Alpena
Hunter Nostrant, President
(989) 356-7245
Primary Contact
MyMichigan Health
Lisa Waibel, 340B Manager
(989) 794-5231
Addresses
Street Address
393 Long Rapids Rd
Alpena, MI 49707
Billing Address
MIDMICHIGAN MEDICAL CENTER - ALPENA
1501 W. Chisholm St
Alpena, MI 49707
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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