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WALGREEN CO.
STD48658 Central Michigan District Health Department
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Covered Entity Details
Entity Name
Central Michigan District Health Department
Subdivision Name
Standish location
Type
Sexually Transmitted Diseases
340B ID
STD48658
Entity Address
4489 W. M-61
Suite 3
Standish, MI 48658
Grant Number
NH25PS005170
Participating Start Date
1/1/2021
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05841
3404 S MARTIN LUTHER KING JR BLVD
LANSING, MI 48910
Pharmacy Comments
Contract Details
Approval Date
1/7/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jaclyn Badger, Health Promotion Director
(989) 773-5921 Ext: 1628
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/7/2025
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