340B Drug Pricing Program Database

Pharmacy Name

TRINITY HEALTH INFUSION PHARMACY CATHEDR

Pharmacy Address

360 DIVISION AVE S STE 1D
GRAND RAPIDS, MI 49503

Pharmacy Comments

6/17/2013 - Pharmacy name and address change error in 3/28/2013, see history for details.

Approval Date

3/14/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Randall Wagner, COO
(616) 685-6957

Contract Pharmacy Representative

Saint Mary's Health Care
Terry Kent Kirkpatrick, Director of Pharmacy Services
(616) 685-6108

Signed By Date

1/15/2013