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HOMETOWN PHARMACY LTC
DSH230046 UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
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Covered Entity Details
Entity Name
UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230046
Entity Address
1500 EAST MEDICAL CENTER DRIVE
ANN ARBOR, MI 48109
Medicare Provider Number
230046
Participating Start Date
1/1/2004
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
HOMETOWN PHARMACY LTC
Pharmacy Address
1123 S MAIN ST
CHELSEA, MI 48118-1426
Pharmacy Comments
Contract Details
Approval Date
10/11/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Miller, President University of Michigan Health Systems
(734) 647-6313
Contract Pharmacy Representative
HomeTown Pharmacy Inc
Rebekah L DesArmo, Director
(231) 301-0354 Ext: 8038
Signed By Date
10/11/2022
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