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MEIJER DISTRIBUTION INC #90
CH05102E HACKLEY COMMUNITY CARE CENTER INC
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Covered Entity Details
Entity Name
HACKLEY COMMUNITY CARE CENTER INC
Subdivision Name
Hackley Community Care Clinton Site
Type
HRSA-Funded Health Center
340B ID
CH05102E
Entity Address
1550 Clinton St
Muskegon, MI 49442-5007
Grant Number
H80CS00684
Participating Start Date
7/19/2021
Last Recertification Date
2/12/2025
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
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Valerie J Blondin, CFO
(231) 733-6657
Contract Pharmacy Representative
Meijer
Katy Diaz, Pharmacy Business Associate
(616) 791-3127
Signed By Date
10/12/2023
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