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WOODWARD DETROIT CVS, L.L.C.
CH05036AY GREAT LAKES BAY HEALTH CENTERS
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Covered Entity Details
Entity Name
GREAT LAKES BAY HEALTH CENTERS
Subdivision Name
Great Lakes Bay Health Centers Mobile Dental 4
Type
HRSA-Funded Health Center
340B ID
CH05036AY
Entity Address
501 Lapeer
Saginaw, MI 48607-1208
Grant Number
H80CS00689
Participating Start Date
4/1/2024
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #11247
225 E STATE ST
PO BOX 96
MONTROSE, MI 48457
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Colleen Evans, CFO
(989) 759-6438
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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