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MEIJER DISTRIBUTION INC #90
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
MEIJER DISTRIBUTION INC #90
Pharmacy Address
2721 WALKER AVE NW
GRAND RAPIDS, MI 49544
Pharmacy Comments
Distribution Center
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/17/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brenda M. Coughlin, President and CEO
(989) 759-6467
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
7/17/2017
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