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VILLAGE PHARMACY II (SASCO VILLAGE, LLC)
DSH230046 UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
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Covered Entity Details
Entity Name
UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230046
Entity Address
1500 EAST MEDICAL CENTER DRIVE
ANN ARBOR, MI 48109
Medicare Provider Number
230046
Participating Start Date
1/1/2004
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
VILLAGE PHARMACY II (SASCO VILLAGE, LLC)
Pharmacy Address
325 N. MAPLE RD
ANN ARBOR, MI 48103
Pharmacy Comments
Contract Details
Approval Date
3/13/2012
Contract Begin Date
3/13/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/12/2015
Pharmacy closed
Contacts
Covered Entity Signing Official
James G. Stevenson, Director of Pharmacy Services
(734) 647-7794
Contract Pharmacy Representative
Jennifer Acra, Owner
(734) 929-8688
Signed By Date
2/28/2012
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