Contract Pharmacy Details

PERRY DRUG STORES, INC.
RRC230030-00 MYMICHIGAN MEDICAL CENTER ALMA

Covered Entity Details

Entity Name

MYMICHIGAN MEDICAL CENTER ALMA

Subdivision Name

Type

Rural Referral Center

340B ID

RRC230030-00

Entity Address

300 E. WARWICK DRIVE
ALMA, MI 48801

Medicare Provider Number

230030

Participating Start Date

10/1/2023

Last Recertification Date

8/16/2024

Pharmacy Details

Pharmacy Name

PERRY DRUG STORES, INC.

Pharmacy Address

RITE AID #4378
1341 WRIGHT AVENUE
ALMA, MI 48801

Pharmacy Comments

Contract Details

Approval Date

4/2/2013

Contract Begin Date

7/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2018
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Mark Santamaria, President and CEO
(989) 466-3258

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

4/2/2013

340B Drug Pricing Program Database