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FAMILY FARE PHARMACY #1994
CH05183H INGHAM, COUNTY OF
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Covered Entity Details
Entity Name
INGHAM, COUNTY OF
Subdivision Name
Mobile Dental Center
Type
HRSA-Funded Health Center
340B ID
CH05183H
Entity Address
2316 S Cedar St
Lansing, MI 48910-3152
Grant Number
H80CS00030
Participating Start Date
4/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
FAMILY FARE PHARMACY #1994
Pharmacy Address
1411 S MAIN ST
EATON RAPIDS, MI 48827-1953
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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