Contract Pharmacy Details

PERRY DRUG STORES, INC.
CH053300 HAMILTON COMMUNITY HEALTH NETWORK, INC.

Covered Entity Details

Entity Name

HAMILTON COMMUNITY HEALTH NETWORK, INC.

Subdivision Name

Hamilton Community Health Network, Inc. - New Main

Type

HRSA-Funded Health Center

340B ID

CH053300

Entity Address

2900 N. Saginaw
Flint, MI 48505-4452

Grant Number

H80CS00435

Participating Start Date

1/1/2000

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

PERRY DRUG STORES, INC.

Pharmacy Address

RITE AID #4333
100 EAST VIENNA ROAD
CLIO, MI 48420

Pharmacy Comments

Contract Details

Approval Date

4/15/2021

Contract Begin Date

5/26/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/15/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

CLARENCE PIERCE, CEO
(810) 406-4951

Contract Pharmacy Representative

RITE AID
REBECCA BADDORF, MANAGER, PHARMACEUTICAL REPLENISHMENT PROGRAMS
(717) 214-2518

Signed By Date

4/15/2021

340B Drug Pricing Program Database