340B Drug Pricing Program Database

Pharmacy Name

PERRY DRUG STORES, INC.

Pharmacy Address

RITE AID #4502
211 E LAKE STREET
TAWAS CITY, MI 48763-9305

Pharmacy Comments

Approval Date

4/17/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/21/2024
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Ann M. Balfour, Chief Administrative Officer
(989) 362-9301

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

4/17/2014