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WALGREEN CO.
CH052200 DOWNRIVER COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
DOWNRIVER COMMUNITY SERVICES INC
Subdivision Name
DOWNRIVER COMMUNITY SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH052200
Entity Address
555 St Clair River Dr
Algonac, MI 48001-1802
Grant Number
H80CS00497
Participating Start Date
10/1/2001
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06053
3990 24TH AVE
PORT HURON, MI 48060
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mike Baranowski, CEO
(586) 270-8055
Contract Pharmacy Representative
Downriver Community Services, Inc.
Bob Bertrand, CFO
(586) 270-8055 Ext: 247
Signed By Date
7/15/2022
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