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WALGREEN CO.
CH05036AP Great Lakes Bay Health Centers
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Covered Entity Details
Entity Name
Great Lakes Bay Health Centers
Subdivision Name
Great Lakes Bay Health Centers Wolverine Vassar #2
Type
HRSA-Funded Health Center
340B ID
CH05036AP
Entity Address
955 Commerce Dr
Vassar, MI 48768
Grant Number
H80CS00689
Participating Start Date
1/1/2018
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05167
416 S. EUCLID AVE.
BAY CITY, MI 48706
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Colleen Evans, CFO
(989) 759-6438
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2023
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