Contract Pharmacy Details

PARKS DRUG STORE INC
CH056430 Grace Health, Inc.

Covered Entity Details

Entity Name

Grace Health, Inc.

Subdivision Name

Grace Health, Inc.

Type

HRSA-Funded Health Center

340B ID

CH056430

Entity Address

181 Emmett St W
Battle Creek, MI 49037-2963

Grant Number

H80CS00586

Participating Start Date

7/1/1998

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

PARKS DRUG STORE INC

Pharmacy Address

318 S SUPERIOR STREET
ALBION, MI 49224

Pharmacy Comments

Contract Details

Approval Date

1/17/2012

Contract Begin Date

1/17/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/1/2018
Ownership change

Contacts

Covered Entity Signing Official

A.J. Jones, CEO
(269) 966-2600

Contract Pharmacy Representative

John Shedd, Owner
(517) 629-9481

Signed By Date

12/28/2011