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WALGREEN CO.
CH05036AD 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 Mobile Dental 1
Type
HRSA-Funded Health Center
340B ID
CH05036AD
Entity Address
501 Lapeer
Saginaw, MI 48607-1208
Grant Number
H80CS00689
Participating Start Date
7/1/2014
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #21378
1841 N MICHIGAN AVE
SAGINAW, MI 48602
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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