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MEIJER INC #33
CHC26573-00 TRAVERSE HEALTH CLINIC AND COALITION
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Covered Entity Details
Entity Name
TRAVERSE HEALTH CLINIC AND COALITION
Subdivision Name
Traverse Health Clinic and Coalition
Type
HRSA-Funded Health Center
340B ID
CHC26573-00
Entity Address
1719 S. Garfield Ave.
Traverse City, MI 49686
Grant Number
H80CS26573
Participating Start Date
4/1/2017
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
MEIJER INC #33
Pharmacy Address
3955 U.S. 31 SOUTH HWY
TRAVERSE CITY, MI 49684
Pharmacy Comments
Contract Details
Approval Date
3/24/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/25/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Arlene Brennan, CEO
(231) 642-5935
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
3/24/2017
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