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WOODWARD DETROIT CVS, 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
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17474
47330 MICHIGAN AVE
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/8/2021
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 J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/8/2021
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