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APEX DRUG STORES, INC.
DSH230132 HURLEY MEDICAL CENTER
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Covered Entity Details
Entity Name
HURLEY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230132
Entity Address
ONE HURLEY PLAZA
FLINT, MI 48503
Medicare Provider Number
230132
Participating Start Date
12/1/1992
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
APEX DRUG STORES, INC.
Pharmacy Address
RITE AID #4504
2838 EAST COURT STREET
FLINT, MI 48506
Pharmacy Comments
Contract Details
Approval Date
1/14/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/25/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Melany Gavulic, President & CEO
(810) 262-6887
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President Managed Care
(717) 975-5978
Signed By Date
1/14/2021
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