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DSH230021AN 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 ST JOSEPH - LCSP CANCER SPECIALISTS ST JOE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230021AN
Medicare Provider Number
230021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/31/2023
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Corewell Health
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Primary Contact
Lakeland Regional Health DBA Corewell Health
Nicole Weston, Business Analyst
(269) 985-4431
Addresses
Street Address
3900 HOLLYWOOD ROAD
SAINT JOSEPH, MI 49085
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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