340B Drug Pricing Program Database
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GALESBURG PHARMACY, LLC
DSH230017 BRONSON METHODIST HOSPITAL
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Covered Entity Details
Entity Name
BRONSON METHODIST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230017
Entity Address
601 JOHN STREET
KALAMAZOO, MI 49007
Medicare Provider Number
230017
Participating Start Date
7/1/2004
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
GALESBURG PHARMACY, LLC
Pharmacy Address
10310 MILLER DR
GALESBURG, MI 49053-9581
Pharmacy Comments
Contract Details
Approval Date
7/1/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907
Contract Pharmacy Representative
Galesburg Pharmacy
Erik Nelson, CEO
(269) 665-9727
Signed By Date
7/1/2021
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