Contract Pharmacy Details

MEIJER DISTRIBUTION INC #90
CHC28352-00 ISABELLA CITIZENS FOR HEALTH, INC.

Covered Entity Details

Entity Name

ISABELLA CITIZENS FOR HEALTH, INC.

Subdivision Name

Isabella Citizens for Health

Type

HRSA-Funded Health Center

340B ID

CHC28352-00

Entity Address

2940 Health Pkwy
Mount Pleasant, MI 48858-9342

Grant Number

H80CS28352

Participating Start Date

4/1/2016

Last Recertification Date

2/4/2019

Entity Termination Date

4/1/2020

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

7/17/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Jennifer White, Chief Executive Officer
(989) 953-5191 Ext: 1

Contract Pharmacy Representative

Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185

Signed By Date

7/17/2017

340B Drug Pricing Program Database