Contract Pharmacy Details

WOODWARD DETROIT CVS, L.L.C.
DSH230207 McLaren Oakland

Covered Entity Details

Entity Name

McLaren Oakland

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230207

Entity Address

50 NORTH PERRY
PONTIAC, MI 48342

Medicare Provider Number

230207

Participating Start Date

1/1/2005

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

WOODWARD DETROIT CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08299
10501 HIGHLAND RD.
WHITE LAKE, MI 48386

Pharmacy Comments

Contract Details

Approval Date

10/15/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/16/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Lynn Marcotte, CFO
(248) 338-5691

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/15/2020

340B Drug Pricing Program Database