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MEIJER DISTRIBUTION INC #90
DSH230075 BRONSON BATTLE CREEK HOSPITAL
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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 DISTRIBUTION INC #90
Pharmacy Address
2721 WALKER AVE NW
GRAND RAPIDS, MI 49544
Pharmacy Comments
Distribution Center
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
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