Contract Pharmacy Details

RITE AID OF MICHIGAN, INC.
CH05036L Great Lakes Bay Health Centers

Covered Entity Details

Entity Name

Great Lakes Bay Health Centers

Subdivision Name

Great Lakes Bay Health Centers Bayside

Type

HRSA-Funded Health Center

340B ID

CH05036L

Entity Address

3884 Monitor Rd
Bay City, MI 48706

Grant Number

H80CS00689

Participating Start Date

7/1/2006

Last Recertification Date

2/27/2025

Pharmacy Details

Pharmacy Name

RITE AID OF MICHIGAN, INC.

Pharmacy Address

RITE AID #1740
500 LAFAYETTE AVENUE
BAY CITY, MI 48708

Pharmacy Comments

Contract Details

Approval Date

10/13/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/22/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Amy Colleen Evans, CFO
(989) 759-6438

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

10/13/2023

340B Drug Pricing Program Database