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WILLIAM BEAUMONT HOSPITAL
DSH230151 Botsford General Hospital d/b/a Corewell Health Farmington Hills Hospital
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Covered Entity Details
Entity Name
Botsford General Hospital d/b/a Corewell Health Farmington Hills Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230151
Entity Address
28050 GRAND RIVER AVE
FARMINGTON HILLS, MI 48336
Medicare Provider Number
230151
Participating Start Date
4/1/2015
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WILLIAM BEAUMONT HOSPITAL
Pharmacy Address
DBA COREWELL HEALTH SPECIALTY PHARMACY
41965 ECORSE RD
STE 100
VAN BUREN TWP, MI 48111
Pharmacy Comments
Contract Details
Approval Date
1/11/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carolyn Wilson, Chief Operating Officer
(947) 522-3338
Contract Pharmacy Representative
Corewell Health East
Scott Sterrett, Manager of Pharmacy
(586) 753-4175
Signed By Date
1/11/2017
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