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MEIJER INC #210
CAH231327-00 SPARROW EATON HOSPITAL
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Covered Entity Details
Entity Name
SPARROW EATON HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231327-00
Entity Address
321 East HARRIS STREET
CHARLOTTE, MI 48813
Medicare Provider Number
231327
Participating Start Date
4/1/2011
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MEIJER INC #210
Pharmacy Address
730 E SAGINAW HWY
GRAND LEDGE, MI 48837-8411
Pharmacy Comments
Contract Details
Approval Date
7/8/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KIM CAPPS, CFO
(517) 543-1050 Ext: 1209
Contract Pharmacy Representative
Meijer
Jeff Romano, Hospital Programs
(616) 791-3171
Signed By Date
7/8/2015
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