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MEIJER DISTRIBUTION INC #90
CH053200 HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
HealthNet Administration/HealthNet Specialty Care at Barrington
Type
HRSA-Funded Health Center
340B ID
CH053200
Entity Address
3403 E Raymond St
Indianapolis, IN 46203
Grant Number
H80CS00114
Participating Start Date
12/1/1992
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
MEIJER DISTRIBUTION INC #90
Pharmacy Address
2721 WALKER AVE NW
GRAND RAPIDS, MI 49544
Pharmacy Comments
Distribution Center
Contract Details
Approval Date
1/13/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rick Diaz, Interim President/ CEO
(317) 957-2035
Contract Pharmacy Representative
Meijer
Jeff Romano, Hospital Programs
(616) 791-3171
Signed By Date
1/13/2017
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