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MEIJER INC #65
CH05220AF DOWNRIVER COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
DOWNRIVER COMMUNITY SERVICES INC
Subdivision Name
DCS Port Huron Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH05220AF
Entity Address
1011 Military St
Port Huron, MI 48060-5416
Grant Number
H80CS00497
Participating Start Date
4/1/2011
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
MEIJER INC #65
Pharmacy Address
15055 HALL RD
UTICA, MI 48315
Pharmacy Comments
Contract Details
Approval Date
1/6/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mike Baranowski, CEO
(586) 270-8055
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
1/6/2020
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