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UNIVERSITY OF MICHIGAN HEALTH-SPARROW
CAH231326-00 SPARROW CLINTON HOSPITAL
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Covered Entity Details
Entity Name
SPARROW CLINTON HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231326-00
Entity Address
805 S. OAKLAND ST
ST. JOHNS, MI 48879
Medicare Provider Number
231326
Participating Start Date
9/22/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
UNIVERSITY OF MICHIGAN HEALTH-SPARROW
Pharmacy Address
GRAND LEDGE PHARMACY PLUS
1015 CHARLEVOIX DR
GRAND LEDGE, MI 48837
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bruce Shively, SHS-CFO Comm Hospitals and Comm Care
(517) 253-6140
Contract Pharmacy Representative
Sparrow
Todd M Belding, Director of Pharmacy Sparrow Health System
(517) 253-2376
Signed By Date
1/13/2023
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