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MEIJER PHARMACY #270
RRC230030-00 MYMICHIGAN MEDICAL CENTER ALMA
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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
MEIJER PHARMACY #270
Pharmacy Address
2805 WEST CHEESMAN RD
ALMA, MI 48801
Pharmacy Comments
Contract Details
Approval Date
7/11/2016
Contract Begin Date
10/1/2016
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
Meijer
Jeff Romano, Hospital Programs
(616) 791-3171
Signed By Date
7/11/2016
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