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ESI MAIL PHARMACY SERVICE
CH05220AF DOWNRIVER COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
DOWNRIVER COMMUNITY SERVICES INC
Subdivision Name
DCS Port Huron Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH05220AF
Entity Address
1011 Military St
Port Huron, MI 48060-5416
Grant Number
H80CS00497
Participating Start Date
4/1/2011
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mike Baranowski, CEO
(586) 270-8055
Contract Pharmacy Representative
Express Scripts
Gene McCabe, 340B Sales Directo
(615) 943-7520
Signed By Date
10/11/2023
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