Contract Pharmacy Details

WAL-MART PHARMACY 10-4383
CH051880 DETROIT HEALTH CARE FOR THE HOMELESS

Covered Entity Details

Entity Name

DETROIT HEALTH CARE FOR THE HOMELESS

Subdivision Name

Waller Health Center on Cathedral Green

Type

HRSA-Funded Health Center

340B ID

CH051880

Entity Address

60 E Warren Ave
Detroit, MI 48201-1312

Grant Number

H80CS00033

Participating Start Date

1/1/2003

Last Recertification Date

2/8/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

WAL-MART PHARMACY 10-4383

Pharmacy Address

5851 MERCURY DRIVE
DEARBORN, MI 48126

Pharmacy Comments

Contract Details

Approval Date

1/24/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Nina Abubakari, Executive Director
(313) 416-6259

Contract Pharmacy Representative

Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498

Signed By Date

1/24/2020

340B Drug Pricing Program Database