Contract Pharmacy Details

UNIVERSITY OF MICHIGAN
DSH230046 UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS

Covered Entity Details

Entity Name

UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230046

Entity Address

1500 EAST MEDICAL CENTER DRIVE
ANN ARBOR, MI 48109

Medicare Provider Number

230046

Participating Start Date

1/1/2004

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

UNIVERSITY OF MICHIGAN

Pharmacy Address

HEALTH SERVICE PHARMACY
207 FLETCHER STREET
ANN ARBOR, MI 48109

Pharmacy Comments

Contract Details

Approval Date

1/9/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jeffrey S. Desmond, Chief Medical Officer
(734) 936-5814

Contract Pharmacy Representative

University Health Service Pharmacy
Darla Bladowski, Pharmacist in Charge
(734) 764-7387

Signed By Date

1/9/2019

340B Drug Pricing Program Database