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WILLIAM BEAUMONT HOSPITAL
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
WILLIAM BEAUMONT HOSPITAL
Pharmacy Address
DBA COREWELL HEALTH HOME INFUSION
31157 WOODWARD AVE STE 101
ROYAL OAK, MI 48073
Pharmacy Comments
Contract Details
Approval Date
4/14/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carolyn Wilson, Chief Operating Officer
(947) 522-3338
Contract Pharmacy Representative
Beaumont Health
Kathleen Pawlicki, VP Chief Pharmacist
(947) 522-1167
Signed By Date
4/14/2019
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