340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RITE AID OF MICHIGAN, INC.
DSH230038 Corewell Health Grand Rapids Hospitals Butterworth Hospital
Print
Covered Entity Details
Entity Name
Corewell Health Grand Rapids Hospitals Butterworth Hospital
Subdivision Name
BUTTERWORTH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH230038
Entity Address
100 MICHIGAN STREET NE
GRAND RAPIDS, MI 49503-2560
Medicare Provider Number
230038
Participating Start Date
4/1/2004
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #1532
9377 CHERRY VALLEY ROAD
CALEDONIA, MI 49316
Pharmacy Comments
Contract Details
Approval Date
4/16/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/22/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Shawn Ulreich, VP Clinical Operations/CNE
(616) 391-1065
Contract Pharmacy Representative
Rite Aid
Charlene Kaiser, VP, Managed Care Operations
(918) 645-6652
Signed By Date
4/16/2022
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