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M.N. PHARMACY LLC
CH05036C Great Lakes Bay Health Centers
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Covered Entity Details
Entity Name
Great Lakes Bay Health Centers
Subdivision Name
Great Lakes Bay Health Centers Janes Street
Type
HRSA-Funded Health Center
340B ID
CH05036C
Entity Address
1522 Janes St
Saginaw, MI 48601
Grant Number
H80CS00689
Participating Start Date
4/1/1999
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
M.N. PHARMACY LLC
Pharmacy Address
DBA AMAZON PHARMACY #003
6701 NW 7TH ST., STE. #199
MIAMI, FL 33126
Pharmacy Comments
Contract Details
Approval Date
1/23/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/24/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brenda Marie Coughlin, President/CEO
(989) 759-6467
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
1/23/2018
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