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WALGREEN CO.
DSH230020 Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital
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Covered Entity Details
Entity Name
Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230020
Entity Address
18101 OAKWOOD BOULEVARD
DEARBORN, MI 48124
Medicare Provider Number
230020
Participating Start Date
7/1/2006
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04585
17071 FORT STREET
RIVERVIEW, MI 48193
Pharmacy Comments
07/18/2013: Added DEA number per OPA instructions. 03/08/2013 zip update (was 48036)
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carolyn Wilson, Chief Operating Officer
(947) 522-3338
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/17/2018
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