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TRINITY HEALTH - MICHIGAN
HV00110 TRINITY HEALTH CORPORATION
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Covered Entity Details
Entity Name
TRINITY HEALTH CORPORATION
Subdivision Name
Special Immunology and Infectious Disease Services
Type
Ryan White Part C
340B ID
HV00110
Entity Address
200 Jefferson SE
GRAND RAPIDS, MI 49503
Grant Number
H76HA00110
Participating Start Date
10/1/2006
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
TRINITY HEALTH - MICHIGAN
Pharmacy Address
D/B/A TRINITY HEALTH PHARMACY - HUDSONVI
3925 32ND AVE
SUITE 200
HUDSONVILLE, MI 49426
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Daniel G. Green, Vice President for Finance
(616) 685-6709
Contract Pharmacy Representative
DSH230059
Terry Kirkpatrick, Director of Pharmacy Services
(616) 685-6108
Signed By Date
10/15/2018
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