340B Drug Pricing Program Database
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DSH230036H MyMichigan Medical Center Alpena (Active)
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Main Details
Name
MyMichigan Medical Center Alpena
Subdivision Name
MyMichigan Medical Center Alpena - Family Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230036H
Medicare Provider Number
230036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/9/2023
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
211 Long Rapids Road
Alpena, MI 49707
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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