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EDWARD W. SPARROW HOSPITAL ASSOCIATION
CAH231326-00 SPARROW CLINTON HOSPITAL
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Covered Entity Details
Entity Name
SPARROW CLINTON HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231326-00
Entity Address
805 S. OAKLAND ST
ST. JOHNS, MI 48879
Medicare Provider Number
231326
Participating Start Date
9/22/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Pharmacy Address
DBA- SPARROW SPECIALTY PHARMACY
1215 E MICHIGAN AVE STE A-1
LANSING, MI 48912
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bruce Shively, SHS-CFO Comm Hospitals and Comm Care
(517) 253-6140
Contract Pharmacy Representative
Sparrow
Todd M Belding, Director of Pharmacy Sparrow Health System
(517) 253-2376
Signed By Date
7/15/2021
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