340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RITE AID OF MICHIGAN, INC.
CAH231339-00 Corewell Health Pennock Hospital
Print
Covered Entity Details
Entity Name
Corewell Health Pennock Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231339-00
Entity Address
1009 west Green Street
Hastings, MI 49058
Medicare Provider Number
231339
Participating Start Date
7/1/2019
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #4740
1339 EAST GRAND RIVER AVE.
PORTLAND, MI 48875
Pharmacy Comments
Contract Details
Approval Date
4/18/2022
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
Michael King, Controller
(269) 948-3122
Contract Pharmacy Representative
Rite Aid
Charlene Kaiser, VP, Managed Care Operations
(918) 645-6652
Signed By Date
4/18/2022
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