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 N Perry St
Pontiac, MI 48342-2217

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