Contract Pharmacy Details

WALGREEN CO.
DSH230020 Oakwood Healthcare, Inc. d/b/a Corewell Health Dearborn Hospital

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 # 04992
15450 MICHIGAN AVE.
DEARBORN, MI 48126

Pharmacy Comments

Contract Details

Approval Date

7/17/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/20/2025
Pharmacy closed

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

340B Drug Pricing Program Database