340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SHOPKO PHARMACY 606
CHC26511-05 UPPER GREAT LAKES FAMILY HEALTH CENTER
Print
Covered Entity Details
Entity Name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Subdivision Name
Ontonagon Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26511-05
Entity Address
751 7th Avenue South
Ontonagon, MI 49953
Grant Number
H80CS26511
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
SHOPKO PHARMACY 606
Pharmacy Address
56835 NORTH STATION DRIVE
CALUMET, MI 49913
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/28/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Donald A. Simila, CEO
(906) 481-8571
Contract Pharmacy Representative
Shopko
Tad Schilke, Director of Rx Merchandising & Marketing
(920) 429-7628
Signed By Date
4/15/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session