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WOODWARD DETROIT CVS, L.L.C.
CH05220AE DOWNRIVER COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
DOWNRIVER COMMUNITY SERVICES INC
Subdivision Name
DCS NEW HAVEN COMMUNITY SERVICES
Type
HRSA-Funded Health Center
340B ID
CH05220AE
Entity Address
58144 GRATIOT AVE
NEW HAVEN, MI 48048
Grant Number
H80CS00497
Participating Start Date
7/1/2006
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08301
940 LAPEER AVE.
PORT HURON, MI 48060
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mike Baranowski, CEO
(586) 270-8055
Contract Pharmacy Representative
Downriver Community Services, Inc.
Bob Bertrand, CFO
(586) 270-8055 Ext: 247
Signed By Date
7/15/2022
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