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MEIJER DISTRIBUTION INC #90
CAH231301-00 KALKASKA MEMORIAL HEALTH CENTER
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Covered Entity Details
Entity Name
KALKASKA MEMORIAL HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231301-00
Entity Address
419 S. CORAL ST.
KALKASKA, MI 49646
Medicare Provider Number
231301
Participating Start Date
8/31/2010
Last Recertification Date
8/21/2024
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
4/18/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Rogols, CEO
(231) 258-7501
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
4/18/2017
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