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RITE AID OF MICHIGAN, INC.
CHC28354-00 OAKLAND INTEGRATED HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
OAKLAND INTEGRATED HEALTHCARE NETWORK
Subdivision Name
Family Medicine Center
Type
HRSA-Funded Health Center
340B ID
CHC28354-00
Entity Address
461 West Huron, Suite 107
Pontiac, MI 48341-1601
Grant Number
H80CS28354
Participating Start Date
4/1/2016
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MICHIGAN, INC.
Pharmacy Address
RITE AID #4697
3 SOUTH TELEGRAPH ROAD
PONTIAC, MI 48341
Pharmacy Comments
Contract Details
Approval Date
3/2/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/10/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Debbie Brinson, CEO
(248) 724-7438
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
3/2/2016
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