Pharmacy Details

MEDSHOP PHARMACY LLC - information as of 4/27/2025 2:04:26 AM

Name
MEDSHOP PHARMACY LLC

Address

1964 W 11 MILE RD
SUITE C
BERKLEY, MI 48072

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	RWI48201	Matrix Human Services	Matrix Quality Care - Ryan White Division	Ryan White Part A	1400 Woodbridge Street		Detroit	MI	07/01/2019		7/1/2019 12:05 AM
Details	RWI48201A	Matrix Human Services		Ryan White Part A	1964 11 Mile Road		Berkley	MI	07/01/2019		7/1/2019 12:05 AM
Details	RWI48201B	Matrix Human Services	William Beaumont Hospital site	Ryan White Part A	3601 W. Thirteen Mile Road		Royal Oak	MI	07/01/2019	01/01/2020	1/1/2020 12:05 AM
Details	RWI48226	Community Health Awareness Group		Ryan White Part A	1300 W. Fort Street		Detroit	MI	07/01/2019		7/1/2019 12:05 AM
Details	STD482072	Matrix Human Services	Matrix Community Health	Sexually Transmitted Diseases	1400 WOODBRIDGE STREET		DETROIT	MI	04/01/2022		4/1/2022 12:01 AM
Details	STD48226	Community Health Awareness Group		Sexually Transmitted Diseases	1300 W. Fort Street		Detroit	MI	07/01/2019		7/1/2019 12:05 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			MEDSHOP PHARMACY LLC 1964 W 11 MILE RD SUITE C BERKLEY, MI 48072	10/3/2019 3:03 PM
Details	Comments	Insert				4/18/2018 10:39 AM
Details	Is Deleted	Insert			False	4/18/2018 10:39 AM
Addresses	Pharmacy Address	Insert			MEDSHOP PHARMACY LLC 30549 STEPHENSON HWY STE B MADISON HEIGHTS, MI 48071	4/18/2018 10:39 AM
Details	Name	Insert			MEDSHOP PHARMACY LLC	4/18/2018 10:39 AM