Contract Pharmacy Details

FAMILY FARE PHARMACY #1904
FQHC638522A NHBP Health Department

Covered Entity Details

Entity Name

NHBP Health Department

Subdivision Name

Type

Tribal Contract/Compact with IHS (P.L. 93-638)

340B ID

FQHC638522A

Entity Address

11177 E. Michigan Ave.
Battle Creek, MI 49014

Grant Number

Participating Start Date

1/1/2017

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

FAMILY FARE PHARMACY #1904

Pharmacy Address

45 COLUMBIA AVE
BATTLE CREEK, MI 49015-3373

Pharmacy Comments

Contract Details

Approval Date

10/14/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/30/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Stephen W. Blann, Chief Financial Officer
(269) 729-5151 Ext: 8389

Contract Pharmacy Representative

SpartanNash
Eddie Garcia, Director of Pharmacy
(616) 878-2975

Signed By Date

10/14/2016

340B Drug Pricing Program Database