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WOODWARD DETROIT CVS, L.L.C.
CHC26511-09 UPPER GREAT LAKES FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Subdivision Name
Calumet Family Health Center- Calumet Ave
Type
HRSA-Funded Health Center
340B ID
CHC26511-09
Entity Address
56720 Calumet Ave.
Calumet, MI 49913
Grant Number
H80CS26511
Participating Start Date
1/1/2017
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16674
3250 US HWY 41 W
MARQUETTE, MI 49855
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald A. Simila, CEO
(906) 481-8571
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2024
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