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MEIJER, INC. #303
CAH231331-00 SPARROW IONIA HOSPITAL
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Covered Entity Details
Entity Name
SPARROW IONIA HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231331-00
Entity Address
3565 S. State Rd
IONIA, MI 48846
Medicare Provider Number
231331
Participating Start Date
10/1/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MEIJER, INC. #303
Pharmacy Address
2770 S. STATE ROAD
IONIA, MI 48846
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WILLIAM ROESER, PRESIDENT AND CHIEF EXECUTIVE OFFICER
(616) 523-1712
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
7/18/2017
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