Contract Pharmacy Details

APEX DRUG STORES, INC.
DSH230036 MyMichigan Medical Center Alpena

Covered Entity Details

Entity Name

MyMichigan Medical Center Alpena

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230036

Entity Address

1501 W. CHISHOLM
ALPENA, MI 49707

Medicare Provider Number

230036

Participating Start Date

7/1/2019

Last Recertification Date

8/16/2024

Pharmacy Details

Pharmacy Name

APEX DRUG STORES, INC.

Pharmacy Address

RITE AID #4532
2140 US HIGHWAY 23 S
ALPENA, MI 49707

Pharmacy Comments

Contract Details

Approval Date

10/11/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/20/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Chuck Sherwin, President
(989) 794-7625

Contract Pharmacy Representative

Rite Aid
Charlene Kaiser, VP, Managed Care Operations
(918) 645-6652

Signed By Date

10/11/2021

340B Drug Pricing Program Database