Contract Pharmacy Details

HOMETOWN PHARMACY, INC.
CH050390 NORTHWEST MICHIGAN HEALTH SERVICES, INC

Covered Entity Details

Entity Name

NORTHWEST MICHIGAN HEALTH SERVICES, INC

Subdivision Name

NORTHWEST MICHIGAN HEALTH SERVICES, INC.

Type

HRSA-Funded Health Center

340B ID

CH050390

Entity Address

10767 E Traverse Hwy
Traverse City, MI 49684-6219

Grant Number

H80CS00669

Participating Start Date

1/1/1997

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

HOMETOWN PHARMACY, INC.

Pharmacy Address

DBA HOMETOWN PHARMACY #21 - SHELBY
178 N MICHIGAN AVE
SHELBY, MI 49455-1028

Pharmacy Comments

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Heidi Britton, Chief Executive Officer
(231) 947-1112

Contract Pharmacy Representative

HomeTown Pharmacy Inc
Rebekah L DesArmo, Director
(231) 301-0354 Ext: 8038

Signed By Date

7/15/2020

340B Drug Pricing Program Database