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RITE AID OF MICHIGAN, INC.
CH05183E INGHAM, COUNTY OF
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Covered Entity Details
Entity Name
INGHAM, COUNTY OF
Subdivision Name
Willow Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH05183E
Entity Address
1115 S. Pennsylvania Ave
Lansing, MI 48912-1669
Grant Number
H80CS00030
Participating Start Date
7/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #1615
1004 EAST MICHIGAN AVENUE
LANSING, MI 48912
Pharmacy Comments
Contract Details
Approval Date
10/15/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Kris Drake, Executive Director/Deputy Health Officer
(517) 887-4361
Contract Pharmacy Representative
Rite Aid
Allison Ferrell, Vice Presicdent Managed Care
(717) 975-5978
Signed By Date
10/15/2023
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