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DSH230021AM LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS (Active)
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Main Details
Name
LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS
Subdivision Name
LAKELAND CANCER SPECIALISTS NILES - LCSP CANCER SPECIALISTS NILES
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230021AM
Medicare Provider Number
230021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/28/2022
Last Recertification Date
8/30/2023
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance CHW
(312) 771-0810
Primary Contact
Spectrum Health
Michael Taylor, Analyst Business Intell.
(269) 262-8670
Addresses
Street Address
42 N. St. Joseph Avenue SUITE 304
NILES, MI 49120
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2024
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