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FOREST COMMUNITY PHARMACY
CH05183H INGHAM, COUNTY OF
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Covered Entity Details
Entity Name
INGHAM, COUNTY OF
Subdivision Name
Mobile Dental Center
Type
HRSA-Funded Health Center
340B ID
CH05183H
Entity Address
2316 S Cedar St
Lansing, MI 48910-3152
Grant Number
H80CS00030
Participating Start Date
4/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
FOREST COMMUNITY PHARMACY
Pharmacy Address
2316 SOUTH CEDAR STREET
SUITE 100
LANSING, MI 48910
Pharmacy Comments
Contract Details
Approval Date
10/5/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris Drake, Executive Director/Deputy Health Officer
(517) 887-4361
Contract Pharmacy Representative
Cardinal Health
Curtis Hartin, Dir. Community Health Center Pharmacies
(864) 430-0906
Signed By Date
10/5/2022
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