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WILLIAM BEAUMONT HOSPITAL
RWI48201C Matrix Human Services
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Covered Entity Details
Entity Name
Matrix Human Services
Subdivision Name
Corewell Health Infection Disease - Westland
Type
Ryan White Part A
340B ID
RWI48201C
Entity Address
2001 S. Merriman Rd. Suite 300
300
Westland, MI 48186
Grant Number
H89HA00021
Participating Start Date
7/1/2024
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WILLIAM BEAUMONT HOSPITAL
Pharmacy Address
DBA COREWELL HEALTH SPECIALTY PHARMACY
41965 ECORSE RD
STE 100
VAN BUREN TWP, MI 48111
Pharmacy Comments
Contract Details
Approval Date
10/9/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Hardik Dalal, SVP, Finance & System-wide Pharmacy Finance
(312) 771-0810
Contract Pharmacy Representative
Corewell Health
Heidi Pillen, VP Amb Pharm Services
(947) 522-1168
Signed By Date
10/9/2024
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