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EHARDT'S PHARMACY INCORPORATED
CAH231330-00 Marlette Regional Hospital
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Covered Entity Details
Entity Name
Marlette Regional Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231330-00
Entity Address
2770 Main Street
Marlette, MI 48453-0307
Medicare Provider Number
231330
Participating Start Date
4/1/2012
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
EHARDT'S PHARMACY INCORPORATED
Pharmacy Address
4436 MAIN ST
BROWN CITY, MI 48416
Pharmacy Comments
Contract Details
Approval Date
7/16/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James L. Singles, CFO
(989) 635-4230
Contract Pharmacy Representative
Ehardt's Pharmacy
Larry Lier, COO/CFO
(810) 679-2284 Ext: 2
Signed By Date
7/16/2014
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