Contract Pharmacy Details

PDS-I MICHIGAN, INC.
CH05036C Great Lakes Bay Health Centers

Covered Entity Details

Entity Name

Great Lakes Bay Health Centers

Subdivision Name

Great Lakes Bay Health Centers Janes Street

Type

HRSA-Funded Health Center

340B ID

CH05036C

Entity Address

1522 Janes St
Saginaw, MI 48601

Grant Number

H80CS00689

Participating Start Date

4/1/1999

Last Recertification Date

2/27/2025

Pharmacy Details

Pharmacy Name

PDS-I MICHIGAN, INC.

Pharmacy Address

RITE AID #4564
531 WEST GENESEE AVENUE
SAGINAW, MI 48602

Pharmacy Comments

Contract Details

Approval Date

4/14/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/13/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Amy Colleen Evans, CFO
(989) 759-6438

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

4/14/2020

340B Drug Pricing Program Database