Covered Entity Details

STD532162 AIDS Resource Center of Wisconsin (Terminated) - information as of 6/17/2025 11:41:11 PM

Main Details

Name

AIDS Resource Center of Wisconsin

Subdivision Name

Vivent Health - Keenan Clinic

Type

Sexually Transmitted Diseases

340B ID

STD532162

Grant Number

5H25PS004336-03

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

In-Kind products or services (see note below; must have been purchased with section 318 funds)
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.

Additional Details

Current Program Status

Terminated

Registration Date

10/4/2018

Participating Start Date

1/1/2019

Participating Approval Date

11/20/2018

Last Recertification Date

5/26/2020

Notice of Funding Opportunity (NOFO) Number

Termination Date
Termination Reason

4/1/2021
Never implemented the 340B Program

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

3200 N 36th Street
Milwaukee, WI 53216

Billing Address

AIDS Resource Center of Wisconsin
820 North Plankinton Avenue
Milwaukee, WI 53203

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

ARCW Pharmacy LLC DBA Vivent Pharmacy
820 N. Plankinton Ave
Milwaukee, WI 53203

Shipping Address 2

ARCW Pharmacy LLC DBA Vivent Pharmacy
600 Williamson Street
H
Madison, WI 53203

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	VIVENT PHARMACY LLC	DBA VIVENT PHARMACY	1311 N 6TH ST STE 101	MILWAUKEE	WI	53212	11/20/2018	01/01/2019		03/15/2019	04/08/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2021 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		3/31/2020 12:00:00 AM	2/18/2021 1:24 PM
Details	State	Update	Termination Request	Active	To Be Terminated	2/18/2021 1:24 PM
Terminations	Termination Comments	Update	Termination Request		This small PrEP/STD clinic did not see any volume. With COVID and other business factors we have no plans to resume or maintain operations at this location.	2/18/2021 1:24 PM
Terminations	Termination Date	Update	Termination Request		4/1/2021 12:00:00 AM	2/18/2021 1:24 PM
Terminations	Termination Effective Date	Update	Termination Request		3/31/2020 12:00:00 AM	2/18/2021 1:24 PM
Terminations	Termination Reason	Update	Termination Request		Never implemented the 340B Program	2/18/2021 1:24 PM
Contacts	Primary Contact	Update	Change Request	Guinn, Daniel VP of Compliance & General Counsel AIDS Resource Center of Wisconsin 6083168602	Guinn, Daniel VP Compliance & General Counsel Vivent Health 6083168602	1/4/2021 1:47 PM
Contacts	Authorizing Official	Update	Change Request	Dyer, Timothy D CFO AIDS Resource Center of Wisconsin, Inc. 4142251542	Dyer, Timothy Denis Executive Vice President & CFO Vivent Health 4142251542	1/4/2021 1:47 PM
Addresses	Shipping Address	Delete	Recertification	ARCW Pharmacy LLC 600 Williamson Street H Madison, WI 53203		5/26/2020 10:45 AM
Addresses	Shipping Address	Delete	Recertification	ARCW Pharmacy LLC DBA AMC Pharmacy 820 N. Plankinton Ave Milwaukee, WI 53203		5/26/2020 10:45 AM
Addresses	Shipping Address	Insert	Recertification		ARCW Pharmacy LLC DBA Vivent Pharmacy 820 N. Plankinton Ave Milwaukee, WI 53203	5/26/2020 10:45 AM
Addresses	Shipping Address	Insert	Recertification		ARCW Pharmacy LLC DBA Vivent Pharmacy 600 Williamson Street H Madison, WI 53203	5/26/2020 10:45 AM
Details	Last Recertification Date	Update	Recertification	5/14/2019 9:18:10 AM	5/26/2020 10:45:45 AM	5/26/2020 10:45 AM
Details	Entity Subname	Update	Recertification	Keenan Clinic	Vivent Health - Keenan Clinic	5/26/2020 10:45 AM
Details	Last Recertification Date	Update	Recertification		5/14/2019 9:18:10 AM	5/14/2019 9:18 AM
Addresses	Shipping Address	Insert	Change Request		ARCW Pharmacy LLC DBA AMC Pharmacy 820 N. Plankinton Ave Milwaukee, WI 53203	4/11/2019 10:10 AM
Addresses	Shipping Address	Insert	Change Request		ARCW Pharmacy LLC 600 Williamson Street H Madison, WI 53203	4/11/2019 10:10 AM
Details	State	Update		Approved	Active	1/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Dyer, Timothy D CFO AIDS Resource Center of Wisconsin, Inc. 4142251542	11/20/2018 4:03 PM
Details	340B ID	Update	New Registration		STD532162	11/20/2018 4:03 PM
Dates	Participating Approval Date	Update	New Registration		11/20/2018 4:03:09 PM	11/20/2018 4:03 PM
Details	State	Update	New Registration	Pending	Approved	11/20/2018 4:03 PM
Dates	Signed By Date	Update	New Registration		10/4/2018 6:03:05 PM	11/20/2018 4:03 PM
Dates	Start Date	Update	New Registration		1/1/2019 12:00:00 AM	11/20/2018 4:03 PM
Addresses	Main Address	Insert	New Registration		3200 N 36th Street Milwaukee, WI 53216	10/4/2018 3:26 PM
Addresses	Billing Address	Insert	New Registration		AIDS Resource Center of Wisconsin 820 North Plankinton Avenue Milwaukee, WI 53203	10/4/2018 3:26 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	10/4/2018 3:26 PM
Contacts	Primary Contact	Insert	New Registration		Guinn, Daniel VP of Compliance & General Counsel AIDS Resource Center of Wisconsin 6083168602	10/4/2018 3:26 PM
Contacts	Authorizing Official	Insert	New Registration		Dyer, Timothy D CFO AIDS Resource Center of Wisconsin, Inc. 4142251542	10/4/2018 3:26 PM
Details	Last Recertification Date	Insert	New Registration			10/4/2018 3:26 PM
Details	Grant Number	Insert	New Registration		5H25PS004336-03	10/4/2018 3:26 PM
Details	340B ID	Insert	New Registration			10/4/2018 3:26 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/4/2018 3:26 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/4/2018 3:26 PM
Details	Medicare Provider Number	Insert	New Registration			10/4/2018 3:26 PM
Details	Entity Name	Insert	New Registration		AIDS Resource Center of Wisconsin	10/4/2018 3:26 PM
Details	Program Code	Insert	New Registration		STD	10/4/2018 3:26 PM
Details	Entity Subname	Insert	New Registration		Keenan Clinic	10/4/2018 3:26 PM
Dates	Participating Approval Date	Insert	New Registration			10/4/2018 3:26 PM
Details	State	Insert	New Registration		Pending	10/4/2018 3:26 PM
Dates	Registration Date	Insert	New Registration		10/4/2018 3:26:44 PM	10/4/2018 3:26 PM
Dates	Signed By Date	Insert	New Registration			10/4/2018 3:26 PM
Dates	Start Date	Insert	New Registration			10/4/2018 3:26 PM
Terminations	Termination Comments	Insert	New Registration			10/4/2018 3:26 PM
Terminations	Termination Date	Insert	New Registration			10/4/2018 3:26 PM
Terminations	Termination Effective Date	Insert	New Registration			10/4/2018 3:26 PM
Terminations	Termination Reason	Insert	New Registration			10/4/2018 3:26 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History