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WOODWARD DETROIT CVS, LLC
CH0537520 COVENANT COMMUNITY CARE, INC.
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Covered Entity Details
Entity Name
COVENANT COMMUNITY CARE, INC.
Subdivision Name
Covenant Michigan Avenue Clinic
Type
HRSA-Funded Health Center
340B ID
CH0537520
Entity Address
5716 Michigan Ave
Detroit, MI 48210-3039
Grant Number
H80CS08738
Participating Start Date
10/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, LLC
Pharmacy Address
DBA: CVS/PHARMACY # 08186
18500 GRAND RIVER
DETROIT, MI 48223
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anna Chavez, Chief Financial Officer
(313) 554-0485
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2021
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