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PERRY DRUG STORES, INC.
DSH230167 MCLAREN GREATER LANSING
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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
PERRY DRUG STORES, INC.
Pharmacy Address
RITE AID #4482
3700 WEST SAGINAW STREET
LANSING, MI 48917
Pharmacy Comments
Contract Details
Approval Date
4/16/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/3/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Dale Thompson, Chief Financial Officer
(517) 975-7555
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President, Managed Care
(717) 975-5968
Signed By Date
4/16/2019
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