Contract Pharmacy Details

RITE AID OF MICHIGAN, INC.
DSH230167 MCLAREN GREATER LANSING

Covered Entity Details

Entity Name

MCLAREN GREATER LANSING

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230167

Entity Address

2900 COLLINS RD.
LANSING, MI 48910

Medicare Provider Number

230167

Participating Start Date

4/1/2025

Last Recertification Date

Pharmacy Details

Pharmacy Name

RITE AID OF MICHIGAN, INC.

Pharmacy Address

RITE AID #4232
3106 EAST SAGINAW STREET
LANSING, MI 48912

Pharmacy Comments

Contract Details

Approval Date

4/15/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/18/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Dale Thompson, Chief Financial Officer
(517) 975-7555

Contract Pharmacy Representative

CaptureRX
Joe Mast, Rite Aid Key Account Manager
(717) 214-8538

Signed By Date

4/15/2019

340B Drug Pricing Program Database