340B Drug Pricing Program Database

Pharmacy Name

MEIJER INC #20

Pharmacy Address

2425 ALPINE AVE., N.W.
GRAND RAPIDS, MI 49544

Pharmacy Comments

Approval Date

7/12/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Tasha Blackmon, CEO
(616) 965-8215

Contract Pharmacy Representative

Meijer
Katy Diaz, Pharmacy Business Associate
(616) 791-3127

Signed By Date

7/12/2019