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CAH231332-09 BRONSON LAKEVIEW HOSPITAL (Active)
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Main Details
Name
BRONSON LAKEVIEW HOSPITAL
Subdivision Name
BRONSON LAKEVIEW HOSPITAL - Family Medicine
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH231332-09
Medicare Provider Number
231332
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/27/2023
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Bronson Healthcare Group
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907
Primary Contact
Bronson Healthcare Group
Troy Shirley, System Director of Pharmacy
(269) 341-8157
Addresses
Street Address
930 BLUE STAR HWY
BRONSON LAKEVIEW FAMILY CARE - BLUE STAR
SOUTH HAVEN, MI 49090-7758
Billing Address
Bronson Accounts Payable
P.O. Box 4001
Kalamazoo, MI 49003-4001
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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