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RITE AID OF MICHIGAN, INC.
CH051980 ALCONA CITIZENS FOR HEALTH, INC.
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Covered Entity Details
Entity Name
ALCONA CITIZENS FOR HEALTH, INC.
Subdivision Name
Alcona Health Center-Lincoln Services
Type
HRSA-Funded Health Center
340B ID
CH051980
Entity Address
177 N Barlow Rd
Harrisville, MI 48740
Grant Number
H80CS00679
Participating Start Date
1/1/2002
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #1691
1133 NORTH US 31
PETOSKEY, MI 49770
Pharmacy Comments
Contract Details
Approval Date
1/6/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/8/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Christine M. Baumgardner, CEO
(989) 736-9868
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
1/6/2014
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