Contract Pharmacy Details

PERRY DRUG STORES, INC.
CH050360 Great Lakes Bay Health Centers

Covered Entity Details

Entity Name

Great Lakes Bay Health Centers

Subdivision Name

Great Lakes Bay Health Centers David R. Gamez

Type

HRSA-Funded Health Center

340B ID

CH050360

Entity Address

501 Lapeer Ave
Saginaw, MI 48607

Grant Number

H80CS00689

Participating Start Date

12/1/1992

Last Recertification Date

2/27/2025

Pharmacy Details

Pharmacy Name

PERRY DRUG STORES, INC.

Pharmacy Address

RITE AID #4330
557 NORTH CEDAR STREET
IMLAY CITY, MI 48444

Pharmacy Comments

Contract Details

Approval Date

7/14/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/22/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Amy Colleen Evans, CFO
(989) 759-6438

Contract Pharmacy Representative

RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086

Signed By Date

7/14/2023

340B Drug Pricing Program Database