340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WOODWARD DETROIT CVS, LLC
DSH230029 TRINITY HEALTH OAKLAND HOSPITAL
Print
Covered Entity Details
Entity Name
TRINITY HEALTH OAKLAND HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230029
Entity Address
44405 WOODWARD AVENUE
PONTIAC, MI 48341
Medicare Provider Number
230029
Participating Start Date
7/1/2022
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WOODWARD DETROIT CVS, LLC
Pharmacy Address
DBA: CVS/PHARMACY # 08166
1156 W. HURON
WATERFORD, MI 48328
Pharmacy Comments
Contract Details
Approval Date
10/16/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/3/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Gusho, Regional Chief Financial Officer
(248) 858-6174
Contract Pharmacy Representative
CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118
Signed By Date
10/16/2015
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