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MCLAREN HOME INFUSION
DSH230207 McLaren Oakland
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Covered Entity Details
Entity Name
McLaren Oakland
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230207
Entity Address
50 NORTH PERRY
PONTIAC, MI 48342
Medicare Provider Number
230207
Participating Start Date
1/1/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
MCLAREN HOME INFUSION
Pharmacy Address
1515 CAL DR
DAVISON, MI 48423-9016
Pharmacy Comments
Contract Details
Approval Date
10/29/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lynn Marcotte, CFO
(248) 338-5691
Contract Pharmacy Representative
MHG
Danielle Hilborn, VP of Pharmacy Services
(810) 496-8857
Signed By Date
10/29/2022
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