340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ALLEGAN MEDICAL CENTER PHARMACY
CAH231328-00 Ascension Borgess Allegan Hospital
Print
Covered Entity Details
Entity Name
Ascension Borgess Allegan Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231328-00
Entity Address
555 LINN STREET
ALLEGAN, MI 49010
Medicare Provider Number
231328
Participating Start Date
9/2/2010
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ALLEGAN MEDICAL CENTER PHARMACY
Pharmacy Address
551 LINN ST
STE 120
ALLEGAN, MI 49010-1591
Pharmacy Comments
Contract Details
Approval Date
7/2/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dorotha Hoffman, Interim Administrator
(269) 686-4162
Contract Pharmacy Representative
Allegan Pharmacy, LLC
Fadi Nuseibeh, Member
(313) 574-3434
Signed By Date
7/2/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session