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AMAZON PHARMACY #006
CH050360 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 David R. Gamez
Type
HRSA-Funded Health Center
340B ID
CH050360
Entity Address
501 Lapeer Ave
Saginaw, MI 48607
Grant Number
H80CS00689
Participating Start Date
12/1/1992
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #006
Pharmacy Address
3620 PLAINFIELD RD
INDIANAPOLIS, IN 46231-7003
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Colleen Evans, CFO
(989) 759-6438
Contract Pharmacy Representative
amazon Pharmacy
Bridget O'Connell, Managing Officer
(737) 443-4728 Ext: 4434728
Signed By Date
10/14/2024
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