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WOODWARD DETROIT CVS, L.L.C.
DSH230142 Oakwood Healthcare, Inc. d/b/a Corewell Health Wayne Hospital
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Covered Entity Details
Entity Name
Oakwood Healthcare, Inc. d/b/a Corewell Health Wayne Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230142
Entity Address
33155 ANNAPOLIS STREET
WAYNE, MI 48184
Medicare Provider Number
230142
Participating Start Date
7/1/2008
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16088
35401 WARREN RD
WESTLAND, MI 48185
Pharmacy Comments
Contract Details
Approval Date
1/9/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Ann Susick, COO
(947) 522-3349
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/9/2023
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