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RITE AID OF MICHIGAN, INC.
CHC26572-04 MyCare Heatlh Center
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Covered Entity Details
Entity Name
MyCare Heatlh Center
Subdivision Name
Groesbeck MyCare
Type
HRSA-Funded Health Center
340B ID
CHC26572-04
Entity Address
43740 N Groesbeck Hwy
Clinton Township, MI 48036-1139
Grant Number
H80CS26572
Participating Start Date
7/1/2014
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #4897
25425 VAN DYKE AVENUE
CENTER LINE, MI 48015
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Karen Wood, Wood
(586) 619-9986 Ext: 13
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/17/2018
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