Contract Pharmacy Details

WOODWARD DETROIT CVS, L.L.C.
CH0537520 COVENANT COMMUNITY CARE, INC.

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, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01150
30900 WOODWARD
ROYAL OAK, MI 48073

Pharmacy Comments

Contract Details

Approval Date

10/15/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/31/2024
Business decision by covered entity and/or pharmacy

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

10/15/2021

340B Drug Pricing Program Database