Contract Pharmacy Details

WOODWARD DETROIT CVS, L.L.C.
RRC230080-00 McLaren Central Michigan

Covered Entity Details

Entity Name

McLaren Central Michigan

Subdivision Name

Type

Rural Referral Center

340B ID

RRC230080-00

Entity Address

1221 South Drive
Mount Pleasant, MI 48858

Medicare Provider Number

230080

Participating Start Date

10/1/2012

Last Recertification Date

9/3/2020

Entity Termination Date

10/1/2021

Pharmacy Details

Pharmacy Name

WOODWARD DETROIT CVS, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY # 10098
1306 S MISSION ST.
MOUNT PLEASANT, MI 48858

Pharmacy Comments

Contract Details

Approval Date

10/13/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

William P. Lawrence, President and CEO
(989) 772-6730

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/13/2016

340B Drug Pricing Program Database