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THE CORNER DRUGSTORE
CHC26511-00 UPPER GREAT LAKES FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Subdivision Name
Houghton Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26511-00
Entity Address
600 MACINNES DR
HOUGHTON, MI 49931
Grant Number
H80CS26511
Participating Start Date
4/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THE CORNER DRUGSTORE
Pharmacy Address
128 W GENESEE ST
IRON RIVER, MI 49935-1437
Pharmacy Comments
Contract Details
Approval Date
7/11/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald A. Simila, CEO
(906) 481-8571
Contract Pharmacy Representative
MK Stores / Snyder Pharmacy
RONALD KATERS, PRESIDENT
(906) 387-4855
Signed By Date
7/11/2014
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