Covered Entity Details

CH0516820 M.G.H. FAMILY HEALTH CENTER (Active) - information as of 6/26/2025 12:24:13 AM

Main Details

Name

M.G.H. FAMILY HEALTH CENTER

Subdivision Name

MUSKEGON FAMILY CARE

Type

HRSA-Funded Health Center

Site ID

BPS-H80-005220

340B ID

CH0516820

Grant Number

H80CS00865

Additional Details

Current Program Status

Active

Registration Date

1/1/2005

Participating Start Date

1/1/2002

Participating Approval Date

1/13/2005

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

M.G.H Family Health Center
Kathy Evett Covington, President and CEO
(231) 737-1741

Primary Contact

M.G.H Family Health Center
Paul L. Schultz, Pharm D
(231) 737-1706

Addresses

Street Address

2201 S Getty St
Muskegon, MI 49444-1207

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
5/5/06 - ADDED MEDICAID # FOR MGH INHOUSE PHARMACY, 9/28/05 - ADDR CHANGE (WAS 2345 SOUTH GETTY STREET), 1/13/05 - ADMIN CORREC - REPLACES RECORD FOR FQHCLA075A	05/06/2010

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MI	2367349	1891898847

Shipping Addresses

Shipping Address 1

MGH FAMILY HEALTH CENTER DBA MUSKEGON FAMILY CARE IN-HOUSE PHARMACY
2201 S. GETTY
MUSKEGON HEIGHTS, MI 49444

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	BENSON DRUG COMPANY, INC	961 SPRING ST		MUSKEGON	MI	49442-3278	04/15/2020	07/01/2020		07/01/2020
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/19/2023	10/01/2023		10/01/2023
Contract Detail	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	04/13/2020	07/01/2020		07/01/2020
Contract Detail	MEIJER INC #19	700 WEST NORTON AVENUE		MUSKEGON	MI	49441	04/13/2020	07/01/2020		07/01/2020
Contract Detail	MEIJER INC #232	5300 S HARVEY ST		MUSKEGON	MI	49444-9767	04/13/2020	07/01/2020		07/01/2020
Contract Detail	MEIJER INC #71	1800 HOLTON ROAD		NORTH MUSKEGON	MI	49445	04/13/2020	07/01/2020		07/01/2020
Contract Detail	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	04/13/2020	07/01/2020		07/01/2020
Contract Detail	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	04/13/2020	07/01/2020		07/01/2020
Contract Detail	MUSKEGON FAMILY CARE PHARMACY	2201 S GETTY STREET		MUSKEGON HEIGHTS	MI	49444	10/05/2005	10/05/2005	09/25/2017	10/02/2017
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WAL-MART PHARMACY 10-2238	1879 E SHERMAN BLVD		MUSKEGON	MI	49444	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WAL-MART PHARMACY 10-3876	3285 HENRY STREET		MUSKEGON	MI	49441	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO	DBA: WALGREENS #12533	819 W MAIN STREET	FREMONT	MI	49412	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO	DBA: WALGREENS #11417	3284 COLBY RD	WHITEHALL	MI	49461-9637	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06279	1991 E APPLE AVE	MUSKEGON	MI	49442	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05315	840 W. SHERMAN BLVD.	MUSKEGON	MI	49441	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07461	1771 HOLTON ROAD	MUSKEGON	MI	49445-1452	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10079	1171 E SHERMAN BLVD	NORTON SHORES	MI	49444-1809	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04835	1000 S. GETTY ST.	MUSKEGON	MI	49442	04/13/2020	07/01/2020		07/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03349	510 N. BEACON BLVD.	GRAND HAVEN	MI	49417	04/13/2020	07/01/2020		07/01/2020
Contract Detail	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	10/11/2023	01/01/2024		01/01/2024
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/19/2023	10/01/2023		10/01/2023
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/19/2023	10/01/2023		10/01/2023
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/19/2023	10/01/2023		10/01/2023
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/11/2023	01/01/2024		01/01/2024
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/11/2023	01/01/2024		01/01/2024
Contract Detail	WATKINS PHARMACY & SURGICAL SUPPLY	1391 E SHERMAN BLVD		MUSKEGON	MI	49444	04/15/2020	07/01/2020	12/01/2023	01/12/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH0516820	Active	BPS-H80-005220	M.G.H. FAMILY HEALTH CENTER	MUSKEGON FAMILY CARE	2201 S Getty St		Muskegon	MI
CH051682A2	Terminated	BPS-H80-005164	M.G.H. FAMILY HEALTH CENTER	MUSKEGON FAMILY CARE DENTAL SVS	1700 OAK AVE STE 010		MUSKEGON	MI

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH0516820	BENSON DRUG COMPANY, INC	961 SPRING ST		MUSKEGON	MI	49442-3278	07/01/2020
CH0516820	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/01/2023
CH0516820	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	07/01/2020
CH0516820	MEIJER INC #19	700 WEST NORTON AVENUE		MUSKEGON	MI	49441	07/01/2020
CH0516820	MEIJER INC #232	5300 S HARVEY ST		MUSKEGON	MI	49444-9767	07/01/2020
CH0516820	MEIJER INC #71	1800 HOLTON ROAD		NORTH MUSKEGON	MI	49445	07/01/2020
CH0516820	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	07/01/2020
CH0516820	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	07/01/2020
CH0516820	MUSKEGON FAMILY CARE PHARMACY	2201 S GETTY STREET		MUSKEGON HEIGHTS	MI	49444	10/05/2005	09/25/2017
CH051682A2	MUSKEGON FAMILY CARE PHARMACY	2201 S GETTY STREET		MUSKEGON HEIGHTS	MI	49444	05/04/2006	04/01/2018
CH0516820	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2020
CH0516820	WAL-MART PHARMACY 10-2238	1879 E SHERMAN BLVD		MUSKEGON	MI	49444	07/01/2020
CH0516820	WAL-MART PHARMACY 10-3876	3285 HENRY STREET		MUSKEGON	MI	49441	07/01/2020
CH0516820	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2020
CH0516820	WALGREEN CO	DBA: WALGREENS #12533	819 W MAIN STREET	FREMONT	MI	49412	07/01/2020
CH0516820	WALGREEN CO	DBA: WALGREENS #11417	3284 COLBY RD	WHITEHALL	MI	49461-9637	07/01/2020
CH0516820	WALGREEN CO.	DBA: WALGREENS # 06279	1991 E APPLE AVE	MUSKEGON	MI	49442	07/01/2020
CH0516820	WALGREEN CO.	DBA: WALGREENS # 05315	840 W. SHERMAN BLVD.	MUSKEGON	MI	49441	07/01/2020
CH0516820	WALGREEN CO.	DBA: WALGREENS # 07461	1771 HOLTON ROAD	MUSKEGON	MI	49445-1452	07/01/2020
CH0516820	WALGREEN CO.	DBA: WALGREENS # 10079	1171 E SHERMAN BLVD	NORTON SHORES	MI	49444-1809	07/01/2020
CH0516820	WALGREEN CO.	DBA: WALGREENS # 04835	1000 S. GETTY ST.	MUSKEGON	MI	49442	07/01/2020
CH0516820	WALGREEN CO.	DBA: WALGREENS # 03349	510 N. BEACON BLVD.	GRAND HAVEN	MI	49417	07/01/2020
CH0516820	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	01/01/2024
CH0516820	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/01/2023
CH0516820	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/01/2023
CH0516820	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/01/2023
CH0516820	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2024
CH0516820	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH0516820	WATKINS PHARMACY & SURGICAL SUPPLY	1391 E SHERMAN BLVD		MUSKEGON	MI	49444	07/01/2020	12/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/8/2024 1:09:25 PM	2/10/2025 12:23:37 PM	2/10/2025 12:23 PM
Contacts	Authorizing Official	Update	Change Request	McDaniel, Tracy CEO MGH Family Health Center 2317399315-1151	Covington, Kathy Evett President and CEO M.G.H Family Health Center 2317371741	10/28/2024 1:43 PM
Details	Last Recertification Date	Update	Recertification	2/7/2023 10:48:06 AM	2/8/2024 1:09:25 PM	2/8/2024 1:09 PM
Details	Last Recertification Date	Update	Recertification	2/1/2022 2:15:34 PM	2/7/2023 10:48:06 AM	2/7/2023 10:48 AM
Details	Last Recertification Date	Update	Recertification	2/4/2021 11:34:56 AM	2/1/2022 2:15:34 PM	2/1/2022 2:15 PM
Contacts	Authorizing Official	Update	Change Request	Figueroa, Sherry Interim CEO MGH Family Health Center 2317399315-1151	McDaniel, Tracy CEO MGH Family Health Center 2317399315-1151	11/29/2021 7:55 AM
Contacts	Authorizing Official	Update	Change Request	Oglesby, Daniel CEO MGH Family Health Center 2317399315-1151	Figueroa, Sherry Interim CEO MGH Family Health Center 2317399315-1151	8/3/2021 12:12 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1891898847	2/4/2021 11:34 AM
Medicaid Billing	NPI: State	Insert	Recertification		MI	2/4/2021 11:34 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1891898847 ( )		2/4/2021 11:34 AM
Details	Last Recertification Date	Update	Recertification	2/3/2020 11:12:39 AM	2/4/2021 11:34:56 AM	2/4/2021 11:34 AM
Contacts	Authorizing Official	Update	Change Request	Alexander, Mitze Interim Chief Executive Officer MGH Family Health Ctr. 2317399315-1151	Oglesby, Daniel CEO MGH Family Health Center 2317399315-1151	4/9/2020 5:51 PM
Details	Last Recertification Date	Update	Recertification	2/5/2019 9:54:49 AM	2/3/2020 11:12:39 AM	2/3/2020 11:12 AM
Contacts	Authorizing Official	Update	Change Request	Bridges, Sheila CHIEF EXECUTIVE OFFICER MGH Family Health Center 2317371751	Alexander, Mitze Interim Chief Executive Officer MGH Family Health Ctr. 2317399315-1151	1/2/2020 2:51 PM
Details	Last Recertification Date	Update	Recertification	2/14/2018 1:36:58 PM	2/5/2019 9:54:49 AM	2/5/2019 9:54 AM
Details	Last Recertification Date	Update	Recertification	2/2/2017 12:00:00 AM	2/14/2018 1:36:58 PM	2/14/2018 1:36 PM
Contacts	Authorizing Official	Update		Bridges, Sheila CHIEF EXECUTIVE OFFICER 2317371751	Bridges, Sheila CHIEF EXECUTIVE OFFICER MGH Family Health Center 2317371751	10/2/2017 9:35 AM
Contacts	Primary Contact	Update	Profile Change Request	Schultz, Paul D. Pharm D M.G.H Family Health Center 2317371744	Schultz, Paul L. Pharm D M.G.H Family Health Center 2317371706	9/25/2017 10:13 AM
Contacts	Primary Contact	Update		Schultz, Paul D. Pharm D 2317371744	Schultz, Paul D. Pharm D M.G.H Family Health Center 2317371744	9/25/2017 9:57 AM
Addresses	Main Address	Insert			2201 S Getty St Muskegon, MI 49444-1207	2/2/2017 10:26 AM
Contacts	Primary Contact	Insert			Schultz, Paul D. Pharm D 2317371744	2/2/2017 10:26 AM
Contacts	Authorizing Official	Update		LUFKIN, THOMAS EXECUTIVE DIRECTOR 2317371750	Bridges, Sheila CHIEF EXECUTIVE OFFICER 2317371751	2/2/2017 10:26 AM
Details	Last Recertification Date	Update		2/15/2016 12:00:00 AM	2/2/2017 12:00:00 AM	2/2/2017 10:26 AM
Medicaid Billing	Medicaid: Is Primary	Update		True	False	2/15/2016 9:21 AM
Details	Last Recertification Date	Update		2/12/2015 12:00:00 AM	2/15/2016 12:00:00 AM	2/15/2016 9:21 AM
Details	Last Recertification Date	Update		2/19/2014 12:00:00 AM	2/12/2015 12:00:00 AM	2/12/2015 10:17 AM
Details	Entity Name	Update		MGH FAMILY HEALTH CENTER DBA MUSKEGON FAMILY CARE	M.G.H. FAMILY HEALTH CENTER	3/31/2014 4:25 PM
Details	Entity Subname	Update			MUSKEGON FAMILY CARE	3/31/2014 4:25 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/19/2014 12:00:00 AM	2/19/2014 9:15 AM
Medicaid Billing	NPI: Number	Insert			1891898847	2/14/2013 10:42 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/14/2013 10:42 AM
Addresses	Shipping Address	Insert			MGH FAMILY HEALTH CENTER DBA MUSKEGON FAMILY CARE IN-HOUSE PHARMACY 2201 S. GETTY MUSKEGON HEIGHTS, MI 49444	5/6/2010 1:09 PM
Contacts	Authorizing Official	Insert			LUFKIN, THOMAS EXECUTIVE DIRECTOR 2317371750	5/6/2010 1:09 PM
Details	Last Recertification Date	Insert				5/6/2010 1:09 PM
Details	Grant Number	Insert			H80CS00865	5/6/2010 1:09 PM
Details	340B ID	Insert			CH0516820	5/6/2010 1:09 PM
Details	Is Authorizing Official EHB Data	Insert				5/6/2010 1:09 PM
Dates	Last Date That 340B Drugs Purchased	Insert				5/6/2010 1:09 PM
Details	Medicare Provider Number	Insert				5/6/2010 1:09 PM
Details	Entity Name	Insert			MGH FAMILY HEALTH CENTER DBA MUSKEGON FAMILY CARE	5/6/2010 1:09 PM
Details	Program Code	Insert			CH	5/6/2010 1:09 PM
Details	Entity Subname	Insert				5/6/2010 1:09 PM
Dates	Participating Approval Date	Insert			1/13/2005 12:00:00 AM	5/6/2010 1:09 PM
Details	State	Insert			Active	5/6/2010 1:09 PM
Dates	Registration Date	Insert			1/1/2005 12:00:00 AM	5/6/2010 1:09 PM
Dates	Signed By Date	Insert				5/6/2010 1:09 PM
Dates	Start Date	Insert			1/1/2002 12:00:00 AM	5/6/2010 1:09 PM
Terminations	Termination Comments	Insert				5/6/2010 1:09 PM
Terminations	Termination Date	Insert				5/6/2010 1:09 PM
Terminations	Termination Effective Date	Insert				5/6/2010 1:09 PM
Terminations	Termination Reason	Insert				5/6/2010 1:09 PM
Details	Comments Public	Insert			5/5/06 - ADDED MEDICAID # FOR MGH INHOUSE PHARMACY, 9/28/05 - ADDR CHANGE (WAS 2345 SOUTH GETTY STREET), 1/13/05 - ADMIN CORREC - REPLACES RECORD FOR FQHCLA075A	5/6/2010 1:09 PM
Medicaid Billing	Medicaid: Is Primary	Insert			True	1/1/2005 12:00 AM
Medicaid Billing	Medicaid: Number	Insert			2367349	1/1/2005 12:00 AM
Medicaid Billing	Medicaid: State	Insert			MI	1/1/2005 12:00 AM

340B Drug Pricing Program Database