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WOODWARD DETROIT CVS, L.L.C.
CH050390 NORTHWEST MICHIGAN HEALTH SERVICES, INC
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Covered Entity Details
Entity Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC
Subdivision Name
NORTHWEST MICHIGAN HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH050390
Entity Address
10767 E Traverse Hwy
Traverse City, MI 49684-6219
Grant Number
H80CS00669
Participating Start Date
1/1/1997
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16197
3130 S AIRPORT RD W
TRAVERSE CITY, MI 49684
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Britton, Chief Executive Officer
(231) 947-1112
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2023
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