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KROGER COLUMBUS CENTRAL FILL #019
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
KROGER COLUMBUS CENTRAL FILL #019
Pharmacy Address
2270 RICKENBACKER PKWY W
COLUMBUS, OH 43217
Pharmacy Comments
Contract Details
Approval Date
1/13/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Colleen Evans, CFO
(989) 759-6438
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
1/13/2025
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