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OAKWOOD HEALTHCARE, INC.
RWI48201B Matrix Human Services
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Covered Entity Details
Entity Name
Matrix Human Services
Subdivision Name
William Beaumont Hospital site
Type
Ryan White Part A
340B ID
RWI48201B
Entity Address
3601 W. Thirteen Mile Road
Royal Oak, MI 48073-6769
Grant Number
H89HA00021
Participating Start Date
1/1/2016
Last Recertification Date
2/5/2019
Entity Termination Date
1/1/2020
Pharmacy Details
Pharmacy Name
OAKWOOD HEALTHCARE, INC.
Pharmacy Address
DBA - COREWELL HEALTH RETAIL PHARMACY WE
2001 S MERRIMAN RD STE 200
WESTLAND, MI 48186
Pharmacy Comments
Contract Details
Approval Date
4/12/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/12/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David Perkins, Vice President of Health Care Services
(248) 819-0489
Contract Pharmacy Representative
Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763
Signed By Date
4/12/2017
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