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MARTIN'S PHARMACY #2322
FQHCLA423 Bowen Health, INC.
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Covered Entity Details
Entity Name
Bowen Health, INC.
Subdivision Name
Bowen Health Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA423
Entity Address
850 N Harrison St
Warsaw, IN 46580-3163
Grant Number
LALCS40296
Participating Start Date
7/1/2021
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
MARTIN'S PHARMACY #2322
Pharmacy Address
SPARTANNASH
865 E JEFFERSON ST
PLYMOUTH, IN 46563
Pharmacy Comments
Contract Details
Approval Date
7/2/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Daniel Carey, Senior VP, Healthcare Quality
(574) 526-1385
Contract Pharmacy Representative
SpartanNash
Eddie Garcia, Director of Pharmacy
(616) 878-2975
Signed By Date
7/2/2021
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