340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO
CH050290 MIDMICHIGAN HEALTH SERVICES, INC
Print
Covered Entity Details
Entity Name
MIDMICHIGAN HEALTH SERVICES, INC
Subdivision Name
MIDMICHIGAN HEALTH PARK - HOUGHTON LAKE
Type
HRSA-Funded Health Center
340B ID
CH050290
Entity Address
9249 W Lake City RD
Houghton Lake, MI 48629-9602
Grant Number
H80CS00190
Participating Start Date
1/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10489
729 W HOUGHTON LAKE DR
PRUDENVILLE, MI 48651-8425
Pharmacy Comments
Contract Details
Approval Date
7/10/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jim Raschke, Executive Director
(989) 422-2105
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/10/2017
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