340B Drug Pricing Program Database
CAREMARK MASSACHUSETTS SPECIALTY PHARMAC
DSH230053 HENRY FORD HOSPITAL - information as of 5/6/2025 12:14:37 AM
Covered Entity Details
Entity Name
HENRY FORD HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230053
Entity Address
2799 WEST GRAND BLVD
DETROIT, MI 48202
Medicare Provider Number
230053
Participating Start Date
10/1/2002
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
CAREMARK MASSACHUSETTS SPECIALTY PHARMAC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
25 BIRCH STREET, BLDG B, SUITE 100
MILFORD, MA 01757
Pharmacy Comments
Contract Details
Approval Date
7/10/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Edward Chadwick, EVP, Finance and Admin & CFO
(313) 876-8714
Contract Pharmacy Representative
Philip Nalaboff, VP Area Specialty Pharmacy
(847) 634-7965
Signed By Date
7/10/2015
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