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RITE AID OF MICHIGAN, INC.
STD489094 INGHAM CO HEALTH DEPT
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Covered Entity Details
Entity Name
INGHAM CO HEALTH DEPT
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD489094
Entity Address
5303 S CEDAR
LANSING, MI 48911
Grant Number
NH25PS005170
Participating Start Date
4/1/2003
Last Recertification Date
5/23/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #4770
2701 SOUTH CEDAR STREET
LANSING, MI 48910
Pharmacy Comments
Contract Details
Approval Date
6/11/2003
Contract Begin Date
6/11/2003
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
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