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THE KROGER CO OF MICHIGAN 887
DSH230167 MCLAREN GREATER LANSING
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Covered Entity Details
Entity Name
MCLAREN GREATER LANSING
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230167
Entity Address
2900 COLLINS RD.
LANSING, MI 48910
Medicare Provider Number
230167
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
THE KROGER CO OF MICHIGAN 887
Pharmacy Address
2495 N CEDAR ST
HOLT, MI 48842
Pharmacy Comments
Contract Details
Approval Date
2/3/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dale Thompson, Chief Financial Officer
(517) 975-7555
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
1/4/2025
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