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WALGREENS SPECIALTY PHARMACY, LLC
RRC230030-00 MYMICHIGAN MEDICAL CENTER ALMA
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Covered Entity Details
Entity Name
MYMICHIGAN MEDICAL CENTER ALMA
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230030-00
Entity Address
300 E. WARWICK DRIVE
ALMA, MI 48801
Medicare Provider Number
230030
Participating Start Date
10/1/2023
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
8/2/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heather R Wager, Director of Finance
(989) 466-3281
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/17/2023
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