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D&W PHARMACY #1903
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
D&W PHARMACY #1903
Pharmacy Address
151 WEST GRAND RIVER
WILLIAMSTON, MI 48895-1317
Pharmacy Comments
Contract Details
Approval Date
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kris Drake, Executive Director/Deputy Health Officer
(517) 887-4361
Contract Pharmacy Representative
Family Fare
Amy Ellis, Director of Pharmacy
(616) 878-2975
Signed By Date
7/11/2024
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