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APEX DRUG STORES, INC.
DSH230151 Botsford General Hospital d/b/a Corewell Health Farmington Hills Hospital
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Covered Entity Details
Entity Name
Botsford General Hospital d/b/a Corewell Health Farmington Hills Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230151
Entity Address
28050 GRAND RIVER AVE
FARMINGTON HILLS, MI 48336
Medicare Provider Number
230151
Participating Start Date
4/1/2015
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
APEX DRUG STORES, INC.
Pharmacy Address
RITE AID #4512
18430 FENKELL STREET
DETROIT, MI 48223
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/7/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carolyn Wilson, Chief Operating Officer
(947) 522-3338
Contract Pharmacy Representative
Rite Aid
Lisa Foster, Manager-Pharmacy
(717) 214-2518
Signed By Date
7/15/2019
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