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HOMETOWN PHARMACY #53 - MUSKEGON
CH050390 NORTHWEST MICHIGAN HEALTH SERVICES, INC
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Covered Entity Details
Entity Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC
Subdivision Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH050390
Entity Address
10767 E Traverse Hwy
Traverse City, MI 49684-6219
Grant Number
H80CS00669
Participating Start Date
1/1/1997
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
HOMETOWN PHARMACY #53 - MUSKEGON
Pharmacy Address
5866 HARVEY ST
MUSKEGON, MI 49444
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Britton, Chief Executive Officer
(231) 947-1112
Contract Pharmacy Representative
HomeTown Pharmacy Inc
Rebekah L DesArmo, Director
(231) 301-0354 Ext: 8038
Signed By Date
1/16/2024
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