Contract Pharmacy Details

MEIJER INC #316
DSH230075 BRONSON BATTLE CREEK HOSPITAL

Covered Entity Details

Entity Name

BRONSON BATTLE CREEK HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230075

Entity Address

300 North Ave.
BATTLE CREEK, MI 49017

Medicare Provider Number

230075

Participating Start Date

1/1/2008

Last Recertification Date

8/28/2024

Pharmacy Details

Pharmacy Name

MEIJER INC #316

Pharmacy Address

2191 COLUMBIA AVENUE WEST
BATTLE CREEK, MI 49015-2847

Pharmacy Comments

Contract Details

Approval Date

4/15/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/1/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Marty Meitz, CFO
(269) 341-8988

Contract Pharmacy Representative

Meijer
Jeff Romano, Hospital Programs
(616) 791-3171

Signed By Date

4/15/2014

340B Drug Pricing Program Database