Contract Pharmacy Details

WOODWARD DETROIT CVS, L.L.C.
RRC230167-00 MCLAREN GREATER LANSING

Covered Entity Details

Entity Name

MCLAREN GREATER LANSING

Subdivision Name

Type

Rural Referral Center

340B ID

RRC230167-00

Entity Address

2900 COLLINS RD.
LANSING, MI 48910

Medicare Provider Number

230167

Participating Start Date

1/1/2025

Last Recertification Date

Entity Termination Date

4/1/2025

Pharmacy Details

Pharmacy Name

WOODWARD DETROIT CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08054
2240 CEDAR ST
HOLT, MI 48842

Pharmacy Comments

Contract Details

Approval Date

11/4/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Dale Thompson, Chief Financial Officer
(517) 975-7555

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/14/2024

340B Drug Pricing Program Database