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THE KROGER CO OF MICHIGAN 795
CH050360 Great Lakes Bay Health Centers
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Covered Entity Details
Entity Name
Great Lakes Bay Health Centers
Subdivision Name
Great Lakes Bay Health Centers David R. Gamez
Type
HRSA-Funded Health Center
340B ID
CH050360
Entity Address
501 Lapeer Ave
Saginaw, MI 48607
Grant Number
H80CS00689
Participating Start Date
12/1/1992
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
THE KROGER CO OF MICHIGAN 795
Pharmacy Address
1315 EAST MAIN
OWOSSO, MI 48867-9039
Pharmacy Comments
Contract Details
Approval Date
1/7/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Colleen Evans, CFO
(989) 759-6438
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/7/2022
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