340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HENRY FORD PHARMACY ADVANTAGE SOUTHFIELD
DSH230195 ST. JOHN MACOMB-OAKLAND HOSPITAL DBA Henry Ford Health Warren Hospital
Print
Covered Entity Details
Entity Name
ST. JOHN MACOMB-OAKLAND HOSPITAL DBA Henry Ford Health Warren Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230195
Entity Address
11800 TWELVE MILE RD.
WARREN, MI 48093
Medicare Provider Number
230195
Participating Start Date
1/1/2021
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
HENRY FORD PHARMACY ADVANTAGE SOUTHFIELD
Pharmacy Address
1191 SOUTH BLVD. E.
ROCHESTER HILLS, MI 48307
Pharmacy Comments
Contract Details
Approval Date
10/22/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Doug Clark, SVP - Corporate Finance
(313) 874-5446
Contract Pharmacy Representative
Henry Ford Hospital
Alexander Mansour, 340B Compliance Officer
(248) 723-0020
Signed By Date
10/22/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session