Contract Pharmacy Details

RITE AID OF MICHIGAN, INC.
CHC26573-00 TRAVERSE HEALTH CLINIC AND COALITION

Covered Entity Details

Entity Name

TRAVERSE HEALTH CLINIC AND COALITION

Subdivision Name

Traverse Health Clinic and Coalition

Type

HRSA-Funded Health Center

340B ID

CHC26573-00

Entity Address

1719 S. Garfield Ave.
Traverse City, MI 49686

Grant Number

H80CS26573

Participating Start Date

4/1/2017

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

RITE AID OF MICHIGAN, INC.

Pharmacy Address

RITE AID #1010
13916 S.W. BAY SHORE DRIVE
TRAVERSE CITY, MI 49684

Pharmacy Comments

Contract Details

Approval Date

4/15/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Krista Tharp, Corporate Compliance and Risk Officer
(231) 935-0799 Ext: 5936

Contract Pharmacy Representative

Rite Aid
Owen McMahon, Group Vice President-Enterprise pharmaceutical Purchasing
(717) 732-0711

Signed By Date

4/15/2024

340B Drug Pricing Program Database