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WALGREENS SPECIALTY PHARMACY, 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
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
7/17/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tony Denton, COO
(734) 647-6623
Contract Pharmacy Representative
University of Michigan Hospitals and Health Centers
Alice Schuman, Asst.Director For Business Operations, UMH Pharmacy Administration
(734) 936-8210
Signed By Date
7/17/2015
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