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MEIJER INC #163
CH052200 DOWNRIVER COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
DOWNRIVER COMMUNITY SERVICES INC
Subdivision Name
DOWNRIVER COMMUNITY SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH052200
Entity Address
555 St Clair River Dr
Algonac, MI 48001-1802
Grant Number
H80CS00497
Participating Start Date
10/1/2001
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
MEIJER INC #163
Pharmacy Address
4775 24TH AVENUE
FORT GRATIOT, MI 48059
Pharmacy Comments
Contract Details
Approval Date
1/6/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
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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