Covered Entity Details

STD78752 Vivent Health Texas, Inc. (Active) - information as of 6/16/2025 1:04:46 AM

Main Details

Name

Vivent Health Texas, Inc.

Subdivision Name

AIDS Services of Austin

Type

Sexually Transmitted Diseases

340B ID

STD78752

Grant Number

NH25PS005182

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

Direct Funding (dollars received from CDC or an intermediate organization)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.

8/31/2024 - 6/30/2026

Additional Details

Current Program Status

Active

Registration Date

4/12/2017

Participating Start Date

7/1/2017

Participating Approval Date

4/24/2017

Last Recertification Date

5/5/2025

Notice of Funding Opportunity (NOFO) Number

CDC-RFA-PS18-180204CONT21

Contacts

Authorizing Official

Vivent Health
Timothy Denis Dyer, Executive Vice President & CFO
(414) 225-1542

Primary Contact

Vivent Health
Daniel Guinn, VP Compliance & General Counsel
(608) 316-8602

Addresses

Street Address

104 E Highland Mall Blvd
Suite 100
Austin, TX 78752

Billing Address

Vivent Health Texas
1311 N 6th Street
Milwaukee, WI 53212

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Shipping Address 1

Vivent Pharmacy
104 E Highland Mall Blvd
Suite 100A
Austin, TX 78752

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AVITA PHARMACY 1028	340B PARTNERS PHARMACY-DALLAS LLC DBA AV	750 FORT WORTH AVE STE H100	DALLAS	TX	75208-1811	04/24/2017	07/01/2017	12/31/2020	01/23/2021
Contract Detail	AVITA PHARMACY 1029	340B PARTNERS PHARMACY LLC D/B/A AVITA P	303 N FRIO ST SUITE 102	SAN ANTONIO	TX	78207-3034	04/24/2017	07/01/2017	12/31/2020	01/23/2021
Contract Detail	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	04/24/2017	07/01/2017	12/31/2020	01/23/2021
Contract Detail	AVITA PHARMACY 1038	AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM	3308 TULANE AVE STE 102	NEW ORLEANS	LA	70119-7170	04/24/2017	07/01/2017	12/31/2020	01/23/2021
Contract Detail	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	04/24/2017	07/01/2017	07/01/2022	07/08/2022
Contract Detail	AVITA PHARMACY 1073	AVITA DRUGS LLC DBA AVITA PHARMACY 1073	300 SOUTH 2ND STREET SUIT 102	MCALLEN	TX	78501	07/05/2018	10/01/2018	07/01/2022	07/08/2022
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/10/2018	01/01/2019	12/23/2020	01/04/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 06892	2402 GUADALUPE ST, UNIT B	AUSTIN	TX	78705	07/13/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 06945	4405 E RIVERSIDE DR	AUSTIN	TX	78741	07/13/2018	10/01/2018	02/04/2022	03/02/2022
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 06822	5256 BURNET RD STE B	AUSTIN	TX	78756	07/13/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CVS PHARMACY, INC.	CVS PHARMACY # 16025	8601 RESEARCH BLVD	AUSTIN	TX	78758	07/13/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 06895	1701 BRIARCLIFF BLVD	AUSTIN	TX	78723	07/13/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00213	5526 S. CONGRESS AVE.	AUSTIN	TX	78745	07/13/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07719	2900 W ANDERSON LN STE 10	AUSTIN	TX	78757	07/13/2018	10/01/2018	02/04/2022	03/02/2022
Contract Detail	H E B FULFILLMENT CENTER		6520 FRATT ROAD	SAN ANTONIO	TX	78218	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #091	2508 E RIVERSIDE DRIVE		AUSTIN	TX	78741	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #161	7112 ED BLUESTEIN		AUSTIN	TX	78723	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #183	9414 N. LAMAR		AUSTIN	TX	78753	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #229	6607 IH-35 SOUTH		AUSTIN	TX	78744	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #425	1000 E. 41ST STREET		AUSTIN	TX	78751	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #465	2701 E 7TH ST		AUSTIN	TX	78702	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #476	500 CANYON RIDGE DRIVE		AUSTIN	TX	78753	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #477	15300 S IH-35		BUDA	TX	78610	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #639	1801 EAST 51ST STREET		AUSTIN	TX	78723	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	HEB PHARMACY #754	2400 S CONGRESS AVE		AUSTIN	TX	78704	01/14/2019	04/01/2019	12/04/2020	12/04/2020
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2859	7950 FLOYD CURL DR. STE #106	SAN ANTONIO	TX	78229	07/16/2018	10/01/2018	12/23/2020	01/04/2021
Contract Detail	VIVENT PHARMACY LLC	DBA VIVENT PHARMACY	600 WILLIAMSON ST STE H	MADISON	WI	53703	01/15/2020	04/01/2020	11/09/2022	11/14/2022
Contract Detail	VIVENT PHARMACY LLC	DBA VIVENT PHARMACY	1311 N 6TH ST STE 101	MILWAUKEE	WI	53212	01/15/2020	04/01/2020	11/09/2022	11/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04704	4501 GUADALUPE ST.	AUSTIN	TX	78751	07/14/2017	10/01/2017	12/02/2020	12/03/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS #10615	5345 N INTERSTATE 35	AUSTIN	TX	78723	07/14/2017	10/01/2017	12/02/2020	12/03/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15672	1920 E RIVERSIDE DR BLDG B	AUSTIN	TX	78741	07/14/2017	10/01/2017	12/02/2020	12/03/2020
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16468	3701 GUADALUPE ST STE 102	AUSTIN	TX	78705	07/14/2017	10/01/2017	12/02/2020	12/03/2020
Contract Detail	WALGREEN CO.	COMMUNITY, A WALGREENS PHARMACY #21228	2500 W. PARMER LN. STE 120	AUSTIN	TX	78727-4232	10/14/2019	01/01/2020	12/02/2020	12/03/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/15/2024 12:52:52 PM	5/5/2025 10:20:45 AM	5/5/2025 10:20 AM
Details	Nature of Support: Support Received To Date	Update	Change Request	12/31/2024 12:00:00 AM	6/30/2026 12:00:00 AM	4/7/2025 12:10 PM
Addresses	Billing Address	Update	Change Request	Vivent Health 1311 N 6th Street Milwaukee, WI 53212	Vivent Health Texas 1311 N 6th Street Milwaukee, WI 53212	11/16/2024 8:34 AM
Details	Nature of Support: Support Received From Date	Update	Change Request	1/1/2020 12:00:00 AM	8/31/2024 12:00:00 AM	11/16/2024 8:34 AM
Details	Nature of Support: Support Received To Date	Update	Change Request	8/31/2024 12:00:00 AM	12/31/2024 12:00:00 AM	11/16/2024 8:34 AM
Details	Last Recertification Date	Update	Recertification	5/18/2023 12:38:35 PM	5/15/2024 12:52:52 PM	5/15/2024 12:52 PM
Details	Nature of Support: Support Received To Date	Update	Change Request	8/31/2023 12:00:00 AM	8/31/2024 12:00:00 AM	2/24/2024 7:46 PM
Addresses	Shipping Address	Update	Change Request	Vivent Pharmacy 6505 Airport Boulevard Suite 100A Austin, TX 78752	Vivent Pharmacy 104 E Highland Mall Blvd Suite 100A Austin, TX 78752	6/14/2023 10:06 AM
Addresses	Billing Address	Insert	Change Request		Vivent Health 1311 N 6th Street Milwaukee, WI 53212	6/14/2023 10:06 AM
Addresses	Main Address	Update	Change Request	6505 Airport Boulevard Suite 100 Austin, TX 78752	104 E Highland Mall Blvd Suite 100 Austin, TX 78752	6/14/2023 10:06 AM
Details	Last Recertification Date	Update	Recertification	5/19/2022 5:54:43 PM	5/18/2023 12:38:35 PM	5/18/2023 12:38 PM
Details	Entity Name	Update	Change Request	AIDS Services of Austin, Inc.	Vivent Health Texas, Inc.	1/11/2023 8:22 AM
Details	Entity Subname	Update	Change Request	Vivent Health	AIDS Services of Austin	1/11/2023 8:22 AM
Addresses	Shipping Address	Delete	Recertification	Vivent Pharmacy 7215 Cameron Rd Suite B Austin, TX 78752		5/19/2022 5:54 PM
Addresses	Shipping Address	Insert	Recertification		Vivent Pharmacy 6505 Airport Boulevard Suite 100A Austin, TX 78752	5/19/2022 5:54 PM
Addresses	Main Address	Update	Recertification	7215 Cameron Rd Austin, TX 78752	6505 Airport Boulevard Suite 100 Austin, TX 78752	5/19/2022 5:54 PM
Details	Nature of Support: Support Received To Date	Update	Recertification	12/31/2021 12:00:00 AM	8/31/2023 12:00:00 AM	5/19/2022 5:54 PM
Details	Last Recertification Date	Update	Recertification	5/19/2021 8:47:58 AM	5/19/2022 5:54:43 PM	5/19/2022 5:54 PM
Details	Nature of Support: Support Received From Date	Update	Recertification		1/1/2020 12:00:00 AM	5/19/2021 8:47 AM
Details	Nature of Support: Support Received To Date	Update	Recertification		12/31/2021 12:00:00 AM	5/19/2021 8:47 AM
Details	Nature Of Support	Delete	Recertification	In-Kind products or services (see note below; must have been purchased with section 318 funds) ()-()		5/19/2021 8:47 AM
Details	Last Recertification Date	Update	Recertification	5/26/2020 10:50:43 AM	5/19/2021 8:47:58 AM	5/19/2021 8:47 AM
Details	NOFO Number	Update	Recertification		CDC-RFA-PS18-180204CONT21	5/19/2021 8:47 AM
Addresses	Shipping Address	Insert	Change Request		Vivent Pharmacy 7215 Cameron Rd Suite B Austin, TX 78752	11/16/2020 7:15 AM
Contacts	Primary Contact	Update	Change Request	Herrera, Ana Director of Clinical Services AIDS Services of Austin, Inc. 5124582437-6169	Guinn, Daniel VP Compliance & General Counsel Vivent Health 6083168602	10/30/2020 9:54 AM
Contacts	Authorizing Official	Update	AO Change Request	Scott, Paul C.E.O. AIDS Services of Austin, Inc. 5124582437	Dyer, Timothy Denis Executive Vice President & CFO Vivent Health 4142251542	10/28/2020 3:14 PM
Details	Grant Number	Update	Change Request	1H25PS004360-02	NH25PS005182	6/1/2020 6:58 PM
Details	Last Recertification Date	Update	Recertification	5/16/2019 11:07:35 AM	5/26/2020 10:50:43 AM	5/26/2020 10:50 AM
Details	Entity Subname	Update	Recertification		Vivent Health	5/26/2020 10:50 AM
Details	Last Recertification Date	Update	Recertification	4/25/2018 3:34:46 PM	5/16/2019 11:07:35 AM	5/16/2019 11:07 AM
Contacts	Primary Contact	Update	Recertification	Scott, Paul C.E.O. AIDS Services of Austin, Inc. 5124582437	Herrera, Ana Director of Clinical Services AIDS Services of Austin, Inc. 5124582437-6169	4/25/2018 3:34 PM
Details	Last Recertification Date	Update	Recertification		4/25/2018 3:34:46 PM	4/25/2018 3:34 PM
Contacts	Authorizing Official	Update		Scott, Paul C.E.O. 5124582437	Scott, Paul C.E.O. AIDS Services of Austin, Inc. 5124582437	1/8/2018 2:38 PM
Contacts	Primary Contact	Update		Scott, Paul C.E.O. 5124582437	Scott, Paul C.E.O. AIDS Services of Austin, Inc. 5124582437	1/8/2018 2:38 PM
Contacts	Signed By	Update		Scott, Paul C.E.O. 5124582437	Scott, Paul C.E.O. AIDS Services of Austin, Inc. 5124582437	1/8/2018 2:38 PM
Contacts	Authorizing Official	Insert			Scott, Paul C.E.O. 5124582437	7/14/2017 4:56 PM
Contacts	Primary Contact	Insert			Scott, Paul C.E.O. 5124582437	7/14/2017 4:56 PM
Contacts	Signed By	Insert			Scott, Paul C.E.O. 5124582437	7/14/2017 4:56 PM
Addresses	Main Address	Insert			7215 Cameron Rd Austin, TX 78752	4/24/2017 5:11 PM
Dates	Participating Approval Date	Update			4/24/2017 12:00:00 AM	4/24/2017 5:11 PM
Details	State	Update		Pending	Active	4/24/2017 5:11 PM
Dates	Start Date	Update			7/1/2017 12:00:00 AM	4/24/2017 5:11 PM
Details	Grant Number	Update		2016-002542-01	1H25PS004360-02	4/21/2017 1:37 PM
Details	340B ID	Update		ONLINE_REG_76690	STD78752	4/21/2017 1:37 PM
Details	Nature Of Support	Insert			Direct Funding (dollars received from CDC or an intermediate organization)	4/12/2017 1:55 PM
Details	Nature Of Support	Insert			In-Kind products or services (see note below; must have been purchased with section 318 funds)	4/12/2017 1:55 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_76690	4/12/2017 1:55 PM
Details	Last Recertification Date	Insert				4/12/2017 1:55 PM
Details	Grant Number	Insert			2016-002542-01	4/12/2017 1:55 PM
Details	340B ID	Insert			ONLINE_REG	4/12/2017 1:55 PM
Details	Is Authorizing Official EHB Data	Insert				4/12/2017 1:55 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/12/2017 1:55 PM
Details	Medicare Provider Number	Insert				4/12/2017 1:55 PM
Details	Entity Name	Insert			AIDS Services of Austin, Inc.	4/12/2017 1:55 PM
Details	Program Code	Insert			STD	4/12/2017 1:55 PM
Details	Entity Subname	Insert				4/12/2017 1:55 PM
Dates	Participating Approval Date	Insert				4/12/2017 1:55 PM
Details	State	Insert			Pending	4/12/2017 1:55 PM
Dates	Registration Date	Insert			4/12/2017 12:00:00 AM	4/12/2017 1:55 PM
Dates	Signed By Date	Insert			4/12/2017 12:00:00 AM	4/12/2017 1:55 PM
Dates	Start Date	Insert				4/12/2017 1:55 PM
Terminations	Termination Comments	Insert				4/12/2017 1:55 PM
Terminations	Termination Date	Insert				4/12/2017 1:55 PM
Terminations	Termination Effective Date	Insert				4/12/2017 1:55 PM
Terminations	Termination Reason	Insert				4/12/2017 1:55 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History