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RRC230117-24 ASCENSION BORGESS HOSPITAL (Active)
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Main Details
Name
ASCENSION BORGESS HOSPITAL
Subdivision Name
ASCENSION BORGESS WOMENS HEALTH W - Ascension Borgess Women's Health
Type
Rural Referral Center
Rural
No
340B ID
RRC230117-24
Medicare Provider Number
230117
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/2/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/6/2023
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Ascension Michigan
Michael McCullough, CFO
(586) 753-0653
Primary Contact
Ascension Rx
Kelsey Fiser, 340B Program Director
(615) 222-5190
Addresses
Street Address
7901 ANGLING RD
STE 1
PORTAGE, MI 49024-0716
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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