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MEIJER DISTRIBUTION INC #90
CAH231338-00 Corewell Health Gerber Hospital
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Covered Entity Details
Entity Name
Corewell Health Gerber Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231338-00
Entity Address
212 S. Sullivan Ave.
FREMONT, MI 49412
Medicare Provider Number
231338
Participating Start Date
4/1/2015
Last Recertification Date
8/23/2024
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
3/24/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Nichols, VP, Finance
(231) 924-1347
Contract Pharmacy Representative
Meijer
Jeff Romano, Hospital Programs
(616) 791-3171
Signed By Date
3/24/2015
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