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WILLIAM BEAUMONT HOSPITAL
DSH230038 Corewell Health Grand Rapids Hospitals Butterworth Hospital
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Covered Entity Details
Entity Name
Corewell Health Grand Rapids Hospitals Butterworth Hospital
Subdivision Name
BUTTERWORTH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH230038
Entity Address
100 MICHIGAN STREET NE
GRAND RAPIDS, MI 49503-2560
Medicare Provider Number
230038
Participating Start Date
4/1/2004
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
WILLIAM BEAUMONT HOSPITAL
Pharmacy Address
DBA - COREWELL HEALTH WILLIAM BEAUMONT U
PHARMACY
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
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
10/15/2024
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