340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MID VALLEY HEALTH SERVICES
DSH230053 HENRY FORD HOSPITAL
Print
Covered Entity Details
Entity Name
HENRY FORD HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230053
Entity Address
2799 WEST GRAND BLVD
DETROIT, MI 48202
Medicare Provider Number
230053
Participating Start Date
10/1/2002
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
MID VALLEY HEALTH SERVICES
Pharmacy Address
2800 MITCHELL RD STE P-U
CERES, CA 95307
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Doug Clark, SVP - Corporate Finance
(313) 874-5446
Contract Pharmacy Representative
AvevoRx
Justin Dent, Vice President of Operations
(336) 210-6580
Signed By Date
1/10/2025
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