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MEIJER DISTRIBUTION INC #90
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 DISTRIBUTION INC #90
Pharmacy Address
2721 WALKER AVE NW
GRAND RAPIDS, MI 49544
Pharmacy Comments
Distribution Center
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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