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Walgreens #21423
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
Walgreens #21423
Pharmacy Address
Walgreens Central Fill #21423
6275 Winchester Blvd
Canal WInchester, OH 43110-6537
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Ann Susick, COO
(947) 522-3349
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2023
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