340B Drug Pricing Program Database

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PDS-I MICHIGAN, INC.
FQHC638421 LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS

Covered Entity Details

LITTLE TRAVERSE BAY BANDS HEALTH DEPARTMENT
Tribal Contract/Compact with IHS (P.L. 93-638)
FQHC638421
1260 Ajijaak Avenue
PETOSKEY, MI 49770
10/1/1999
2/14/2025


Pharmacy Details

RITE AID #4410
630 WEST MITCHELL STREET
PETOSKEY, MI 49770

Contract Details

4/5/2013
7/1/2013

2/1/2022
Business decision by covered entity and/or pharmacy


Contacts


SHARON SIERZPUTOWSKI, HEALTH DIRECTOR
(231) 242-1610



Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
4/5/2013