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HASTINGS PHARMACY
CH052030 CHERRY STREET SERVICES, INC.
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Covered Entity Details
Entity Name
CHERRY STREET SERVICES, INC.
Subdivision Name
CHERRY STREET HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH052030
Entity Address
550 Cherry St SE
Grand Rapids, MI 49503-4748
Grant Number
H80CS00770
Participating Start Date
7/1/2002
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
HASTINGS PHARMACY
Pharmacy Address
400 W STATE ST
HASTINGS, MI 49058-1640
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tasha Blackmon, CEO
(616) 965-8215
Contract Pharmacy Representative
Hastings Pharmacy
Russ Boblet, CFO
(269) 945-3777
Signed By Date
7/14/2020
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