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PROCARE PHARMACY, L.L.C.
DSH230270 OAKWOOD HEALTHCARE INC. dba Corewell Health Taylor Hospital
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Covered Entity Details
Entity Name
OAKWOOD HEALTHCARE INC. dba Corewell Health Taylor Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230270
Entity Address
10000 Telegraph Road
TAYLOR, MI 48180
Medicare Provider Number
230270
Participating Start Date
10/1/2015
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
7/12/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carolyn Wilson, Chief Operating Officer
(947) 522-3338
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2021
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