340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FAMILY FARE PHARMACY #1524
DSH230080 MCLAREN CENTRAL MICHIGAN
Print
Covered Entity Details
Entity Name
MCLAREN CENTRAL MICHIGAN
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230080
Entity Address
1221 SOUTH DRIVE
MT PLEASANT, MI 48858
Medicare Provider Number
230080
Participating Start Date
10/1/2021
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
FAMILY FARE PHARMACY #1524
Pharmacy Address
1204 N STATE ST
GLADWIN, MI 48624
Pharmacy Comments
Contract Details
Approval Date
1/18/2023
Contract Begin Date
2/8/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/5/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tara Soules, Chief Financial Officer
(989) 772-6818
Contract Pharmacy Representative
Prevos Family Markets, Inc., Family Fare, LLC
Kristina Rooney, Pharmacy Contract Admin
(616) 878-2761
Signed By Date
1/18/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session