Covered Entity Details

CHC28352-02 ISABELLA CITIZENS FOR HEALTH, INC. (Active) - information as of 6/4/2025 1:16:34 PM

Main Details

Name

ISABELLA CITIZENS FOR HEALTH, INC.

Subdivision Name

Isabella Citizens for Health

Type

HRSA-Funded Health Center

Site ID

BPS-H80-029935

340B ID

CHC28352-02

Grant Number

H80CS28352

Additional Details

Current Program Status

Active

Registration Date

11/18/2019

Participating Start Date

1/1/2020

Participating Approval Date

11/24/2019

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Isabella Citizens for Health
Jennifer White, Chief Executive Officer
(989) 953-5191 Ext: 1

Primary Contact

Isabella Citizens for Health, Inc
Brian Karl Ross, CFO
(989) 953-5191 Ext: 2

Addresses

Street Address

2790 Health Pkwy
Mount Pleasant, MI 48858

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
No records to display.

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	1104177195,1528843422	1942842471,1104177195,1528843422

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	01/03/2024	04/01/2024		04/01/2024
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	01/03/2024	04/01/2024		04/01/2024
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	01/03/2024	04/01/2024		04/01/2024
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	01/03/2024	04/01/2024		04/01/2024
Contract Detail	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	01/03/2024	04/01/2024		04/01/2024
Contract Detail	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	02/26/2020	04/01/2020		04/01/2020
Contract Detail	MEIJER INC #69	1015 PICKARD ST		MT PLEASANT	MI	48858	02/26/2020	04/01/2020		04/01/2020
Contract Detail	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	02/26/2020	04/01/2020		04/01/2020
Contract Detail	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	02/26/2020	04/01/2020		04/01/2020
Contract Detail	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	04/15/2025	07/01/2025		04/15/2025
Contract Detail	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	04/15/2025	07/01/2025		04/15/2025
Contract Detail	PERRY DRUG STORES, INC.	RITE AID #4505	117 NORTH MISSION STREET	MT PLEASANT	MI	48858	04/02/2020	07/01/2020	07/23/2024	07/23/2024
Contract Detail	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	01/03/2024	04/01/2024		04/01/2024
Contract Detail	RITE AID OF MICHIGAN, INC.	RITE AID #3234	146 NORTH CORNING STREET	FARWELL	MI	48622	04/02/2020	07/01/2020	07/30/2024	07/30/2024
Contract Detail	RITE AID OF MICHIGAN, INC.	RITE AID #3253	161 BEECH STREET PO BOX 376	HARRISON	MI	48625	10/10/2023	01/01/2024	07/01/2024	07/08/2024
Contract Detail	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	01/03/2024	04/01/2024		04/01/2024
Contract Detail	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	01/03/2024	04/01/2024		04/01/2024
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WAL-MART PHARMACY 10-1428	4730 ENCORE BLVD		MOUNT PLEASANT	MI	48858	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WALGREEN ARIZONA DRUG CO.	WALGREENS CENTRAL FILL #21372	120 N 83RD AVE STE 200	TOLLESON	AZ	85353	07/01/2022	10/01/2022		10/01/2022
Contract Detail	WALGREEN CO	DBA: WALGREENS #12346	903 N MISSION	MOUNT PLEASANT	MI	48858	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WALGREEN CO	DBA: WALGREENS #11887	1141 N MCEWAN ST	CLARE	MI	48617-1107	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10250	1420 WRIGHT AVENUE	ALMA	MI	48801	02/26/2020	04/01/2020	11/08/2023	11/08/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07247	1309 S MISSION ST	MT PLEASANT	MI	48858-4207	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05097	4989 STATE ST	SAGINAW	MI	48603	02/26/2020	04/01/2020		04/01/2020
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/03/2024	04/01/2024		04/01/2024
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/03/2024	04/01/2024		04/01/2024
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/03/2024	04/01/2024		04/01/2024
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/04/2023	04/01/2023		04/01/2023
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/02/2023	01/01/2024		01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC28352-00	Terminated	BPS-H80-014976	ISABELLA CITIZENS FOR HEALTH, INC.	Isabella Citizens for Health	2940 Health Pkwy	Mount Pleasant	MI
CHC28352-01	Terminated	BPS-H80-017390	ISABELLA CITIZENS FOR HEALTH, INC.	Isabella Citizens for Health II	2935 Health Parkway	Mount Pleasant	MI
CHC28352-02	Active	BPS-H80-029935	ISABELLA CITIZENS FOR HEALTH, INC.	Isabella Citizens for Health	2790 Health Pkwy	Mount Pleasant	MI
CHC28352-03	Active	BPS-H80-037075	ISABELLA CITIZENS FOR HEALTH	Women's Health Center of Isabella Citizens for Health, Inc.	1201 South Drive STE 220	Mount Pleasant	MI
CHC28352-04	Approved	BPS-H80-038887	ISABELLA CITIZENS FOR HEALTH	Farwell Health Center	522 E Main St	Farwell	MI

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC28352-02	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/01/2024
CHC28352-02	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/01/2024
CHC28352-02	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	13925 YALE AVE STE 145		IRVINE	CA	92620-2670	04/01/2024
CHC28352-02	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/01/2024
CHC28352-02	DOGWOOD PHARMACY LLC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER RD STE K	GREENVILLE	SC	29607-6541	04/01/2024
CHC28352-00	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	10/01/2017	04/01/2020
CHC28352-02	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	04/01/2020
CHC28352-00	MEIJER INC #69	1015 PICKARD ST		MT PLEASANT	MI	48858	10/01/2017	04/01/2020
CHC28352-02	MEIJER INC #69	1015 PICKARD ST		MT PLEASANT	MI	48858	04/01/2020
CHC28352-03	MEIJER INC #69	1015 PICKARD ST		MT PLEASANT	MI	48858	04/01/2025
CHC28352-00	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	10/01/2017	04/01/2020
CHC28352-02	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	04/01/2020
CHC28352-00	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	10/01/2017	04/01/2020
CHC28352-02	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	04/01/2020
CHC28352-02	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	07/01/2025
CHC28352-02	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	07/01/2025
CHC28352-02	PERRY DRUG STORES, INC.	RITE AID #4505	117 NORTH MISSION STREET	MT PLEASANT	MI	48858	07/01/2020	07/23/2024
CHC28352-02	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/01/2024
CHC28352-02	RITE AID OF MICHIGAN, INC.	RITE AID #3234	146 NORTH CORNING STREET	FARWELL	MI	48622	07/01/2020	07/30/2024
CHC28352-02	RITE AID OF MICHIGAN, INC.	RITE AID #3253	161 BEECH STREET PO BOX 376	HARRISON	MI	48625	01/01/2024	07/01/2024
CHC28352-02	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/01/2024
CHC28352-02	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	04/01/2024
CHC28352-00	SUPERX DRUGS CORPORATION	DBA: THE KROGER CO OF MI #889	4080 E. BLUEGRASS	MT PLEASANT	MI	48858	10/01/2017	04/02/2019
CHC28352-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2019	04/01/2020
CHC28352-02	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2020
CHC28352-00	WAL-MART PHARMACY 10-1422	7700 N ALGER RD		ALMA	MI	48801	10/01/2017	04/22/2019
CHC28352-00	WAL-MART PHARMACY 10-1428	4730 ENCORE BLVD		MOUNT PLEASANT	MI	48858	10/01/2017	04/01/2020
CHC28352-02	WAL-MART PHARMACY 10-1428	4730 ENCORE BLVD		MOUNT PLEASANT	MI	48858	04/01/2020
CHC28352-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2019	04/01/2020
CHC28352-02	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2020
CHC28352-02	WALGREEN ARIZONA DRUG CO.	WALGREENS CENTRAL FILL #21372	120 N 83RD AVE STE 200	TOLLESON	AZ	85353	10/01/2022
CHC28352-00	WALGREEN CO	DBA: WALGREENS #11887	1141 N MCEWAN ST	CLARE	MI	48617-1107	07/01/2016	04/01/2020
CHC28352-00	WALGREEN CO	DBA: WALGREENS #12346	903 N MISSION	MOUNT PLEASANT	MI	48858	07/01/2016	04/01/2020
CHC28352-02	WALGREEN CO	DBA: WALGREENS #12346	903 N MISSION	MOUNT PLEASANT	MI	48858	04/01/2020
CHC28352-02	WALGREEN CO	DBA: WALGREENS #11887	1141 N MCEWAN ST	CLARE	MI	48617-1107	04/01/2020
CHC28352-03	WALGREEN CO	DBA: WALGREENS #12346	903 N MISSION	MOUNT PLEASANT	MI	48858	04/01/2025
CHC28352-00	WALGREEN CO.	DBA: WALGREENS # 05097	4989 STATE ST	SAGINAW	MI	48603	07/01/2016	04/01/2020
CHC28352-00	WALGREEN CO.	DBA: WALGREENS # 07247	1309 S MISSION ST	MT PLEASANT	MI	48858-4207	07/01/2016	04/01/2020
CHC28352-00	WALGREEN CO.	DBA: WALGREENS # 10250	1420 WRIGHT AVENUE	ALMA	MI	48801	07/01/2016	04/01/2020
CHC28352-02	WALGREEN CO.	DBA: WALGREENS # 10250	1420 WRIGHT AVENUE	ALMA	MI	48801	04/01/2020	11/08/2023
CHC28352-02	WALGREEN CO.	DBA: WALGREENS # 07247	1309 S MISSION ST	MT PLEASANT	MI	48858-4207	04/01/2020
CHC28352-02	WALGREEN CO.	DBA: WALGREENS # 05097	4989 STATE ST	SAGINAW	MI	48603	04/01/2020
CHC28352-03	WALGREEN CO.	DBA: WALGREENS # 07247	1309 S MISSION ST	MT PLEASANT	MI	48858-4207	04/01/2025
CHC28352-02	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/01/2024
CHC28352-02	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/01/2024
CHC28352-02	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/01/2024
CHC28352-02	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC28352-02	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/29/2024 4:09:30 PM	2/10/2025 12:54:53 PM	2/10/2025 12:54 PM
Contacts	Primary Contact	Update	Change Request	Punches, Bunny Finance Director Isabella Citizens for Health 9897795642	Ross, Brian Karl CFO Isabella Citizens for Health, Inc 9899535191-2	8/26/2024 9:43 PM
Contacts	Authorizing Official	Update	Change Request	White, Jennifer Chief Executive Officer Isabella Citizens for Health 9899535191	White, Jennifer Chief Executive Officer Isabella Citizens for Health 9899535191-1	8/26/2024 1:26 PM
Contacts	Signed By	Update	Change Request	White, Jennifer Chief Executive Officer Isabella Citizens for Health 9899535191	White, Jennifer Chief Executive Officer Isabella Citizens for Health 9899535191-1	8/26/2024 1:26 PM
Details	Last Recertification Date	Update	Recertification	1/31/2023 7:53:06 AM	1/29/2024 4:09:30 PM	1/29/2024 4:09 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/10/2023 11:14 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1104177195	10/10/2023 11:14 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		MI	10/10/2023 11:14 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/10/2023 11:14 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1528843422	10/10/2023 11:14 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		MI	10/10/2023 11:14 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1104177195	10/10/2023 11:14 AM
Medicaid Billing	NPI: State	Insert	Change Request		MI	10/10/2023 11:14 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1528843422	10/10/2023 11:14 AM
Medicaid Billing	NPI: State	Insert	Change Request		MI	10/10/2023 11:14 AM
Details	Last Recertification Date	Update	Recertification	2/7/2022 10:49:57 AM	1/31/2023 7:53:06 AM	1/31/2023 7:53 AM
Details	Last Recertification Date	Update	Recertification	2/4/2021 11:44:14 AM	2/7/2022 10:49:57 AM	2/7/2022 10:49 AM
Medicaid Billing	NPI: State	Update	Recertification		MI	2/4/2021 11:44 AM
Details	Last Recertification Date	Update	Recertification	1/30/2020 1:45:07 PM	2/4/2021 11:44:14 AM	2/4/2021 11:44 AM
Details	Last Recertification Date	Update	Recertification		1/30/2020 1:45:07 PM	1/30/2020 1:45 PM
Details	State	Update		Approved	Active	1/1/2020 12:04 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1942842471	12/12/2019 1:41 PM
Contacts	Signed By	Insert	New Registration		White, Jennifer Chief Executive Officer Isabella Citizens for Health 9899535191	11/24/2019 5:11 PM
Details	340B ID	Update	New Registration		CHC28352-02	11/24/2019 5:11 PM
Dates	Participating Approval Date	Update	New Registration		11/24/2019 5:11:22 PM	11/24/2019 5:11 PM
Details	State	Update	New Registration	Pending	Approved	11/24/2019 5:11 PM
Dates	Signed By Date	Update	New Registration		11/18/2019 5:04:43 PM	11/24/2019 5:11 PM
Dates	Start Date	Update	New Registration		1/1/2020 12:00:00 AM	11/24/2019 5:11 PM
Addresses	Main Address	Insert	New Registration		2790 Health Pkwy Mount Pleasant, MI 48858	11/18/2019 5:04 PM
Contacts	Authorizing Official	Insert	New Registration		White, Jennifer Chief Executive Officer Isabella Citizens for Health 9899535191	11/18/2019 5:04 PM
Contacts	Primary Contact	Insert	New Registration		Punches, Bunny Finance Director Isabella Citizens for Health 9897795642	11/18/2019 5:04 PM
Details	Last Recertification Date	Insert	New Registration			11/18/2019 5:04 PM
Details	Grant Number	Insert	New Registration		H80CS28352	11/18/2019 5:04 PM
Details	340B ID	Insert	New Registration			11/18/2019 5:04 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			11/18/2019 5:04 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			11/18/2019 5:04 PM
Details	Medicare Provider Number	Insert	New Registration			11/18/2019 5:04 PM
Details	Entity Name	Insert	New Registration		ISABELLA CITIZENS FOR HEALTH, INC.	11/18/2019 5:04 PM
Details	Program Code	Insert	New Registration		CH	11/18/2019 5:04 PM
Details	Entity Subname	Insert	New Registration		Isabella Citizens for Health	11/18/2019 5:04 PM
Dates	Participating Approval Date	Insert	New Registration			11/18/2019 5:04 PM
Details	State	Insert	New Registration		Pending	11/18/2019 5:04 PM
Dates	Registration Date	Insert	New Registration		11/18/2019 5:04:40 PM	11/18/2019 5:04 PM
Dates	Signed By Date	Insert	New Registration			11/18/2019 5:04 PM
Dates	Start Date	Insert	New Registration			11/18/2019 5:04 PM
Terminations	Termination Comments	Insert	New Registration			11/18/2019 5:04 PM
Terminations	Termination Date	Insert	New Registration			11/18/2019 5:04 PM
Terminations	Termination Effective Date	Insert	New Registration			11/18/2019 5:04 PM
Terminations	Termination Reason	Insert	New Registration			11/18/2019 5:04 PM

340B Drug Pricing Program Database