340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FAIRWAY DRUGS INC
DSH230053 HENRY FORD HOSPITAL
Print
Covered Entity Details
Entity Name
HENRY FORD HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230053
Entity Address
2799 WEST GRAND BLVD
DETROIT, MI 48202
Medicare Provider Number
230053
Participating Start Date
10/1/2002
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
FAIRWAY DRUGS INC
Pharmacy Address
19332 E TEN MILE
EASTPOINTE, MI 48021-1495
Pharmacy Comments
Contract Details
Approval Date
12/12/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/3/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Connelly, CFO
(313) 876-8714
Contract Pharmacy Representative
Thomas Rheaume, Owner
(586) 771-0030
Signed By Date
10/15/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session