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PROCARE PHARMACY, L.L.C.
DSH230142 Oakwood Healthcare, Inc. d/b/a Corewell Health Wayne Hospital
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Covered Entity Details
Entity Name
Oakwood Healthcare, Inc. d/b/a Corewell Health Wayne Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230142
Entity Address
33155 ANNAPOLIS STREET
WAYNE, MI 48184
Medicare Provider Number
230142
Participating Start Date
7/1/2008
Last Recertification Date
8/21/2024
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
10/7/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lee Ann Odom, President, Shared Services
(947) 522-2653
Contract Pharmacy Representative
CVS Health
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
10/7/2021
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