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MEIJER, INC.
DSH230038 Corewell Health Grand Rapids Hospitals Butterworth Hospital
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Covered Entity Details
Entity Name
Corewell Health Grand Rapids Hospitals Butterworth Hospital
Subdivision Name
BUTTERWORTH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH230038
Entity Address
100 MICHIGAN STREET NE
GRAND RAPIDS, MI 49503-2560
Medicare Provider Number
230038
Participating Start Date
4/1/2004
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
MEIJER, INC.
Pharmacy Address
DBA MEIJER PHARMACY #466
1840 WEALTHY ST SE STE 1F-55
GRAND RAPIDS, MI 49506
Pharmacy Comments
Contract Details
Approval Date
10/9/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Contract Pharmacy Representative
Meijer
Holly VanLente, Pharmaceutical Buyer
(616) 735-8014
Signed By Date
10/9/2024
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