Covered Entity Details

CH05643N Grace Health, Inc. (Active) - information as of 4/29/2025 11:56:47 PM

Main Details

Name

Grace Health, Inc.

Subdivision Name

Lakeview High School

Type

HRSA-Funded Health Center

Site ID

BPS-H80-027994

340B ID

CH05643N

Grant Number

H80CS00586

Additional Details

Current Program Status

Active

Registration Date

7/14/2022

Participating Start Date

10/1/2022

Participating Approval Date

7/25/2022

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Grace Health
Peter Chang, President / CEO
(269) 966-2600

Primary Contact

Grace Health
Jodi Pant, Director of Finance
(269) 441-1948

Addresses

Street Address

15060 Helmer Rd S Rm 1
Battle Creek, MI 49015-9641

Billing Address

Grace Health
181 W. Emmett St
Battle Creek, MI 49037

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		1518945278,1285131896,1609346105,1205688710

Shipping Addresses

Shipping Address 1

Grace Health
181 W. Emmett St
Battle Creek, MI 49037

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH056430	Active	BPS-H80-004049	Grace Health, Inc.	Grace Health, Inc.	181 Emmett St W	Battle Creek	MI
CH05643A	Active	BPS-H80-004007	Grace Health, Inc.	Grace Health, Inc.	115 Market Place	Albion	MI
CH05643B	Terminated	BPS-H80-019296	GRACE HEALTH, INC.	Grace Health, Inc.	62 East Michigan Avenue	Battle Creek	MI
CH05643C	ToBeTerminated	BPS-H80-027166	Grace Health, Inc.	Lakeview Middle School	300 South 28th Street RM 15	Battle Creek	MI
CH05643D	Active	BPS-H80-027164	Grace Health, Inc.	Battle Creek Central High School	100 West Van Buren Street RM 102	Battle Creek	MI
CH05643E	Active	BPS-H80-027171	Grace Health, Inc.	W.K. Preparatory High School	60 West Van Buren Street RM 308	Battle Creek	MI
CH05643F	Active	BPS-H80-027167	Grace Health, Inc.	Northwestern Middle School	176 Limit Street RM 138A	Battle Creek	MI
CH05643G	Active	BPS-H80-027165	Grace Health, Inc.	Springfield Middle School	1023 Avenue A RM 9	Springfield	MI
CH05643H	Active	BPS-H80-018453	Grace Health, Inc.	Homer Community School District	403 Hillsdale St RM 112	Homer	MI
CH05643J	Active	BPS-H80-020895	Grace Health, Inc.	Purdy Elementary - Pennfield Schools	6510 Purdy Dr RM 10	Battle Creek	MI
CH05643K	Active	BPS-H80-020987	Grace Health, Inc.	North Penn Elementary - Pennfield Schools	7422 Poorman Rd RM 17	Battle Creek	MI
CH05643L	Active	BPS-H80-030550	Grace Health, Inc.	Verona Elementary School	825 Capital Ave NE Rm 101	Battle Creek	MI
CH05643M	Active	BPS-H80-020892	Grace Health, Inc.	Dunlap Elementary - Pennfield Schools	8465 Pennfield Rd RM 15	Battle Creek	MI
CH05643N	Active	BPS-H80-027994	Grace Health, Inc.	Lakeview High School	15060 Helmer Rd S Rm 1	Battle Creek	MI
CH05643P	Active	BPS-H80-035313	Grace Health, Inc.	Harper Creek High School	12677 Beadle Lake Rd RM 104	Battle Creek	MI
CH05643Q	Active	BPS-H80-038632	Grace Health, Inc.	Grace Health, Inc.	175 College Street STE 100	Battle Creek	MI
CH05643R	Active	BPS-H80-038922	Grace Health, Inc.	Lakeview Middle School	300 South 28th Street RM 101A	Battle Creek	MI
CH05643S	Active	BPS-H80-038790	Grace Health, Inc.	Grace Health Mobile Dental Unit #1	181 Emmett St W	Battle Creek	MI
CH05643T	Active	BPS-H80-039044	Grace Health, Inc.	Beadle Lake Elementary School	8175 C Drive North RM 10	Battle Creek	MI
CH05643U	Active	BPS-H80-039027	Grace Health, Inc.	Ann J Kellogg Elementary School	306 Champion Street RM 116A	Battle Creek	MI

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH056430	FAMILY FARE PHARMACY #1904	45 COLUMBIA AVE		BATTLE CREEK	MI	49015-3373	01/01/2017	01/01/2017
CH056430	FAMILY FARE PHARMACY #1972	1525 W MICHIGAN AVE		BATTLE CREEK	MI	49037	01/01/2017	01/01/2017
CH056430	FAMILY FARE PHARMACY #1979	1603 CAPITAL NE		BATTLE CREEK	MI	49017-1661	01/01/2017	01/01/2017
CH056430	MEIJER DISTRIBUTION INC #90	2721 WALKER AVE NW		GRAND RAPIDS	MI	49544	01/01/2016
CH056430	MEIJER INC #195	6405 B DRIVE NORTH		BATTLE CREEK	MI	49014	01/01/2016
CH056430	MEIJER INC #316	2191 COLUMBIA AVENUE WEST		BATTLE CREEK	MI	49015-2847	01/01/2016
CH056430	MEIJER PHARMACY #464	41255 COCA COLA DR.		BELLEVILLE	MI	48111-1827	01/01/2017
CH056430	MEIJER STORES LIMITED PARTNERSHIP	D/B/A MEIJER PHARMACY #463	1515 PROFIT DR.	FORT WAYNE	IN	46808	01/01/2016
CH056430	PARKS DRUG STORE INC	318 S SUPERIOR STREET		ALBION	MI	49224	01/17/2012	09/01/2018
CH056430	PERRY DRUG STORES, INC.	RITE AID #4369	30 EAST COLUMBIA AVE SUITE A	BATTLE CREEK	MI	49015	07/01/2019	11/13/2023
CH056430	RITE AID OF MICHIGAN, INC.	RITE AID #2425	600 NORTH AVENUE	BATTLE CREEK	MI	49017	10/26/2012	01/26/2023
CH056430	RITE AID OF MICHIGAN, INC.	RITE AID #1474	1434 WEST MICHIGAN AVENUE	BATTLE CREEK	MI	49037	10/26/2012	07/01/2024
CH056430	RITE AID OF MICHIGAN, INC.	RITE AID #4963	890 EAST MICHIGAN AVENUE	BATTLE CREEK	MI	49014	07/01/2019	06/29/2021
CH056430	WAL-MART PHARMACY 10-2080	6020 B DRIVE NORTH		BATTLE CREEK	MI	49014	10/10/2012	01/01/2017
CH056430	WALGREEN CO.	DBA: WALGREENS #15633	797 CAPITAL AVE NE	BATTLE CREEK	MI	49017	04/01/2013
CH056430	WALGREEN CO.	DBA: WALGREENS # 03147	918 RIVERVIEW DRIVE	KALAMAZOO	MI	49048	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 04991	3016 S WESTNEDGE AVE	KALAMAZOO	MI	49008	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 05315	840 W. SHERMAN BLVD.	MUSKEGON	MI	49441	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 06092	500 E CHICAGO ST	COLDWATER	MI	49036	04/01/2013
CH056430	WALGREEN CO.	DBA: WALGREENS # 07158	50 COLUMBIA AVENUE W	BATTLE CREEK	MI	49015	04/01/2013
CH056430	WALGREEN CO.	DBA: WALGREENS # 07430	5020 W MAIN	KALAMAZOO	MI	49009	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 07894	5815 GULL RD	KALAMAZOO	MI	49048-1094	04/01/2013
CH056430	WALGREEN CO.	DBA: WALGREENS # 07934	301 S US HWY 131	THREE RIVERS	MI	49093	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 09130	5991 BECKLEY RD	BATTLE CREEK	MI	49014	04/01/2013
CH056430	WALGREEN CO.	DBA: WALGREENS # 10080	7920 SHAVER RD	PORTAGE	MI	49024	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 10081	5933 S WESTNEDGE AVE	PORTAGE	MI	49002-1455	04/01/2013	03/23/2018
CH056430	WALGREEN CO.	DBA: WALGREENS # 10513	605 NORTH AVE	BATTLE CREEK	MI	49017-3230	04/01/2013
CH056430	WALGREEN CO.	DBA: WALGREENS #12777	4365 LAKE MICHIGAN DR NW	WALKER	MI	49534	04/01/2013	03/23/2018
CH056430	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	01/01/2024
CH056430	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	04/01/2013	06/30/2015
CH056430	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/01/2013	06/30/2015

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/6/2024 2:19:30 PM	2/10/2025 1:18:27 PM	2/10/2025 1:18 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1205688710	7/1/2024 11:12 AM
Medicaid Billing	NPI: State	Insert	Change Request		MI	7/1/2024 11:12 AM
Details	Last Recertification Date	Update	Recertification	2/15/2023 11:24:04 AM	2/6/2024 2:19:30 PM	2/6/2024 2:19 PM
Contacts	Primary Contact	Update	Profile Change Request	Pant, Jodi Manager of Finance Grace Health 2694411948	Pant, Jodi Director of Finance Grace Health 2694411948	10/9/2023 2:59 PM
Details	Last Recertification Date	Update	Recertification		2/15/2023 11:24:04 AM	2/15/2023 11:24 AM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Chang, Peter President / CEO Grace Health 2699662600	7/25/2022 11:14 AM
Details	340B ID	Update	New Registration		CH05643N	7/25/2022 11:14 AM
Dates	Participating Approval Date	Update	New Registration		7/25/2022 11:14:55 AM	7/25/2022 11:14 AM
Details	State	Update	New Registration	Pending	Approved	7/25/2022 11:14 AM
Dates	Signed By Date	Update	New Registration		7/14/2022 12:29:21 PM	7/25/2022 11:14 AM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	7/25/2022 11:14 AM
Addresses	Main Address	Insert	New Registration		15060 Helmer Rd S Rm 1 Battle Creek, MI 49015-9641	7/14/2022 10:55 AM
Addresses	Billing Address	Insert	New Registration		Grace Health 181 W. Emmett St Battle Creek, MI 49037	7/14/2022 10:55 AM
Addresses	Shipping Address	Insert	New Registration		Grace Health 181 W. Emmett St Battle Creek, MI 49037	7/14/2022 10:55 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1518945278	7/14/2022 10:55 AM
Medicaid Billing	NPI: State	Insert	New Registration		MI	7/14/2022 10:55 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1285131896	7/14/2022 10:55 AM
Medicaid Billing	NPI: State	Insert	New Registration		MI	7/14/2022 10:55 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1609346105	7/14/2022 10:55 AM
Medicaid Billing	NPI: State	Insert	New Registration		MI	7/14/2022 10:55 AM
Contacts	Authorizing Official	Insert	New Registration		Chang, Peter President / CEO Grace Health 2699662600	7/14/2022 10:55 AM
Contacts	Primary Contact	Insert	New Registration		Pant, Jodi Manager of Finance Grace Health 2694411948	7/14/2022 10:55 AM
Details	Assistance Received From Date	Insert	New Registration			7/14/2022 10:55 AM
Details	Assistance Received To Date	Insert	New Registration			7/14/2022 10:55 AM
Details	Last Recertification Date	Insert	New Registration			7/14/2022 10:55 AM
Details	Grant Number	Insert	New Registration		H80CS00586	7/14/2022 10:55 AM
Details	340B ID	Insert	New Registration			7/14/2022 10:55 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/14/2022 10:55 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/14/2022 10:55 AM
Details	Medicare Provider Number	Insert	New Registration			7/14/2022 10:55 AM
Details	Entity Name	Insert	New Registration		Grace Health, Inc.	7/14/2022 10:55 AM
Details	NOFO Number	Insert	New Registration			7/14/2022 10:55 AM
Details	Program Code	Insert	New Registration		CH	7/14/2022 10:55 AM
Details	Entity Subname	Insert	New Registration		Lakeview High School	7/14/2022 10:55 AM
Dates	Participating Approval Date	Insert	New Registration			7/14/2022 10:55 AM
Details	State	Insert	New Registration		Pending	7/14/2022 10:55 AM
Dates	Registration Date	Insert	New Registration		7/14/2022 10:55:15 AM	7/14/2022 10:55 AM
Dates	Signed By Date	Insert	New Registration			7/14/2022 10:55 AM
Dates	Start Date	Insert	New Registration			7/14/2022 10:55 AM
Terminations	Termination Comments	Insert	New Registration			7/14/2022 10:55 AM
Terminations	Termination Date	Insert	New Registration			7/14/2022 10:55 AM
Terminations	Termination Effective Date	Insert	New Registration			7/14/2022 10:55 AM
Terminations	Termination Reason	Insert	New Registration			7/14/2022 10:55 AM

340B Drug Pricing Program Database