Contract Pharmacy Details

WALGREEN CO
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

WALGREEN CO

Pharmacy Address

DBA: WALGREENS #11887
1141 N MCEWAN ST
CLARE, MI 48617-1107

Pharmacy Comments

Contract Details

Approval Date

4/15/2015

Contract Begin Date

7/1/2015

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

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/15/2015

340B Drug Pricing Program Database