Contract Pharmacy Details

PERRY DRUG STORES, 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

PERRY DRUG STORES, INC.

Pharmacy Address

RITE AID #4382
2910 ASHMAN STREET
MIDLAND, MI 48640

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

7/1/2024
Business decision by covered entity and/or pharmacy

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