Contract Pharmacy Details

RITE AID OF MICHIGAN, INC.
TB489094 INGHAM COUNTY HEALTH DEPARTMENT

Covered Entity Details

Entity Name

INGHAM COUNTY HEALTH DEPARTMENT

Subdivision Name

Type

Tuberculosis

340B ID

TB489094

Entity Address

5303 S. CEDAR ST.
LANSING, MI 48911

Grant Number

NU52PS910290-01-00

Participating Start Date

1/1/2000

Last Recertification Date

6/2/2025

Pharmacy Details

Pharmacy Name

RITE AID OF MICHIGAN, INC.

Pharmacy Address

RITE AID #4770
2701 SOUTH CEDAR STREET
LANSING, MI 48910

Pharmacy Comments

Contract Details

Approval Date

6/11/2003

Contract Begin Date

6/11/2003

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/30/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

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

Signed By Date

340B Drug Pricing Program Database