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RITE AID OF MICHIGAN, INC.
CH05036AZ 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 Medical 3
Type
HRSA-Funded Health Center
340B ID
CH05036AZ
Entity Address
501 Lapeer Ave
Saginaw, MI 48607-1208
Grant Number
H80CS00689
Participating Start Date
4/1/2024
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #1487
3050 BAY ROAD
SAGINAW, MI 48603
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
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
4/15/2024
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