340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LAKELAND PHARMACY SHOPPE #2 - ST. JOSEPH
DSH230021 LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS
Print
Covered Entity Details
Entity Name
LAKELAND REGIONAL HEALTH SYSTEM LAKELAND MEDICAL CENTER ST JOSEPH DBA COREWELL HEALTH LAKELAND HOSPITALS
Subdivision Name
LAKELAND HOSPITAL - ST JOSEPH
Type
Disproportionate Share Hospital
340B ID
DSH230021
Entity Address
1234 NAPIER AVENUE
ST JOSEPH, MI 49085
Medicare Provider Number
230021
Participating Start Date
10/1/2004
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
LAKELAND PHARMACY SHOPPE #2 - ST. JOSEPH
Pharmacy Address
THE PHARMACY SHOPPE, INC.
1234 NAPIER AVE STE C101
SAINT JOSEPH, MI 49085
Pharmacy Comments
Contract Details
Approval Date
1/6/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Vincent Konopacki, VP Finance & CFO
(269) 313-7188 Ext: 2693137188
Contract Pharmacy Representative
Specrum Health Lakeland
Elizabeth Davenport, Pharmacy Manager
(269) 876-7255
Signed By Date
1/6/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session