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MEIJER STORES LIMITED PARTNERSHIP
DSH230075 BRONSON BATTLE CREEK HOSPITAL
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Covered Entity Details
Entity Name
BRONSON BATTLE CREEK HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230075
Entity Address
300 North Ave.
BATTLE CREEK, MI 49017
Medicare Provider Number
230075
Participating Start Date
1/1/2008
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
MEIJER STORES LIMITED PARTNERSHIP
Pharmacy Address
D/B/A MEIJER PHARMACY #463
1515 PROFIT DR.
FORT WAYNE, IN 46808
Pharmacy Comments
Contract Details
Approval Date
1/7/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
1/7/2019
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