340B Drug Pricing Program Database
ASCENSION PHARMACY SERVICES, LLC
RRC230117-00 ASCENSION BORGESS HOSPITAL - information as of 4/25/2025 6:49:12 PM
Covered Entity Details
Entity Name
ASCENSION BORGESS HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230117-00
Entity Address
1521 GULL ROAD
KALAMAZOO, MI 49048
Medicare Provider Number
230117
Participating Start Date
1/1/2024
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ASCENSION PHARMACY SERVICES, LLC
Pharmacy Address
DBA ASCENSION RX 1303
30055 NORTHWESTERN HWY STE 225
FARMINGTON HILLS, MI 48334
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael McCullough, CFO
(586) 753-0653
Contract Pharmacy Representative
Ascension Michigan Pharmacy
Suzanne Noe, Pharmacist
(248) 865-3770
Signed By Date
1/5/2024
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