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WOODWARD DETROIT CVS, L.L.C.
CH050360 Great Lakes Bay Health Centers
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Covered Entity Details
Entity Name
Great Lakes Bay Health Centers
Subdivision Name
Great Lakes Bay Health Centers David R. Gamez
Type
HRSA-Funded Health Center
340B ID
CH050360
Entity Address
501 Lapeer Ave
Saginaw, MI 48607
Grant Number
H80CS00689
Participating Start Date
12/1/1992
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #11252
2040 S CEDAR
IMLAY CITY, MI 48444
Pharmacy Comments
Contract Details
Approval Date
10/4/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Amy Colleen Evans, CFO
(989) 759-6438
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/4/2021
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