Covered Entity Details

STD63042 WASHINGTON UNIVERSITY IN ST. LOUIS (Active) - information as of 5/3/2025 11:28:00 PM

Main Details

Name

WASHINGTON UNIVERSITY IN ST. LOUIS

Subdivision Name

Washington University Infectious Diseases Clinic North County

Type

Sexually Transmitted Diseases

340B ID

STD63042

Grant Number

NU62PS924838

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.

9/30/2023

Additional Details

Current Program Status

Active

Registration Date

10/14/2022

Participating Start Date

1/1/2023

Participating Approval Date

11/17/2022

Last Recertification Date

5/9/2024

Notice of Funding Opportunity (NOFO) Number

CDC-RFA-PS-24-0047

Contacts

Authorizing Official

Washington University School of Medicine
Tina M Markovich, Program Director
(314) 747-3071

Primary Contact

Washington University ID Clinic
Megan Clare Lengerman, Director of 340B Programs & Initiatives
(314) 362-7595

Addresses

Street Address

1 VILLAGE SQ SHOPPING CTR
SUITE 1
HAZELWOOD, MO 63042-1817

Billing Address

WASHINGTON UNIVERSITY IN ST LOUIS INFECTIOUS DISEASES CLINIC NORTH COUNTY
660 S EUCLID AVE
SAINT LOUIS, MO 63110-1010

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

WASH U SCHOOL OF MEDICINE - INFECTIOUS DISEASES PHARMACY
620 S TAYLOR AVE
ROOM 202
SAINT LOUIS, MO 63110

Shipping Address 2

WASH U - VILLAGE SQUARE PHARMACY
1 VILLAGE SQUARE SHOPPING STE 1
RM 103
HAZELWOOD, MO 63042

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04024	5890 NORTH BELT WEST	BELLEVILLE	IL	62226	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04602	2510 STATE STREET	EAST ST LOUIS	IL	62205	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04832	6505 N. ILLINOIS	FAIRVIEW HEIGHTS	IL	62208	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04337	172 E. MCARTHUR	BETHALTO	IL	62010	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03136	1201 CAMP JACKSON	CAHOKIA	IL	62206	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04599	704 CAMBRIDGE BLVD.	OFALLON	IL	62269	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04865	515 CARLYLE AVE.	BELLEVILLE	IL	62221	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04407	3732 NAMEOKI	GRANITE CITY	IL	62040	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02490	401 BELTLINE	COLLINSVILLE	IL	62234	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	01/17/2023	04/01/2023		04/01/2023
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/17/2023	04/01/2023		04/01/2023
Contract Detail	WALGREEN CO	DBA: WALGREENS #10588	1400 N GRAND BLVD	SAINT LOUIS	MO	63106-1909	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO	DBA: WALGREENS #12395	6607 STATE ROUTE 162	MARYVILLE	IL	62062	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06472	4218 LINDELL BLVD	ST LOUIS	MO	63108-2916	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #12927	2340 HAMPTON AVE	ST LOUIS	MO	63139	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03652	1001 BOWLES AVENUE	FENTON	MO	63026	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15941	10500 SAINT CHARLES ROCK ROAD	SAINT ANN	MO	63074	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06432	2401 S BRENTWOOD BLVD	BRENTWOOD	MO	63144	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #21346	3527 CHOUTEAU AVE	SAINT LOUIS	MO	63103	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15311	115 N EUCLID AVE STE A	SAINT LOUIS	MO	63108	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02741	12400 OLD HALLS FERRY	BLACK JACK	MO	63033	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09771	9801 MANCHESTER RD	SAINT LOUIS	MO	63119-1227	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16552	628 N NEW BALLAS RD STE A	CREVE COEUR	MO	63141	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04671	7501 OLIVE BLVD	UNIVERSITY CITY	MO	63130	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	WALGREENS #16326	2315 S KINGSHIGHWAY BLVD	SAINT LOUIS	MO	63110	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09714	9978 KENNERLY ROAD	ST LOUIS	MO	63128-2704	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05894	6733 CLAYTON RD	CLAYTON	MO	63117	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02994	9285 HALLS FERRY RD	JENNINGS	MO	63136	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06755	3920 HAMPTON AVE	ST LOUIS	MO	63109-1401	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03686	4140 S. BROADWAY	ST LOUIS	MO	63118	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02227	250 E. 4TH STREET	EUREKA	MO	63025	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 00854	5764 S LINDBERGH BLVD	ST LOUIS	MO	63123	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10082	10941 OLIVE BLVD	CREVE COEUR	MO	63141	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 11744	1302 CLARKSON CLAYTON CENTER	ELLISVILLE	MO	63011	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 01633	7398 N LINDBERGH BLVD	HAZELWOOD	MO	63042	11/17/2022	01/01/2023	07/01/2024	07/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04090	2920 HIGHWAY K	O FALLON	MO	63368	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03714	2610 STATE ST	ALTON	IL	62002-5150	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07680	8571 WATSON ROAD	WEBSTER GROVES	MO	63119-5218	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS #11711	1530 LAFAYETTE AVE.	SAINT LOUIS	MO	63104	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06023	190 N FLORISSANT RD	FERGUSON	MO	63135	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02971	2 GRANDVIEW PLZ SHP CTR STE A	FLORISSANT	MO	63033	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS #10205	640 EDWARDSVILLE RD	TROY	IL	62294	11/17/2022	01/01/2023		01/01/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07296	3720 N KINGSHIGHWAY BLVD	ST LOUIS	MO	63115-1701	11/17/2022	01/01/2023	03/27/2025	03/27/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04834	1225 UNION BLVD	ST LOUIS	MO	63113	11/17/2022	01/01/2023	03/28/2023	04/19/2023
Contract Detail	Walgreens Central Fill #21394	2601 Hughes Road	Suite 103	Liberty	MO	64068	01/17/2023	04/01/2023		04/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Lengerman, Megan Clare 340B Project Manager Washington University ID Clinic 3143627595	Lengerman, Megan Clare Director of 340B Programs & Initiatives Washington University ID Clinic 3143627595	4/17/2025 1:32 PM
Details	Grant Number	Update	Change Request	NH25PS005235	NU62PS924838	4/3/2025 6:17 AM
Details	NOFO Number	Update	Change Request	CDC-RFA-PS-23-0011	CDC-RFA-PS-24-0047	4/3/2025 6:17 AM
Addresses	Main Address	Update	Recertification	1 Village Square Suite 1 Hazelwood, MO 63042-1817	1 VILLAGE SQ SHOPPING CTR SUITE 1 HAZELWOOD, MO 63042-1817	5/9/2024 8:49 AM
Addresses	Billing Address	Update	Recertification	WASHINGTON UNIVERSITY IN ST LOUIS INFECTIOUS DISEASES CLINIC NORTH COUNTY 660 S EUCLID CAMPUS BOX 8051 SAINT LOUIS, MO 63110-1010	WASHINGTON UNIVERSITY IN ST LOUIS INFECTIOUS DISEASES CLINIC NORTH COUNTY 660 S EUCLID AVE SAINT LOUIS, MO 63110-1010	5/9/2024 8:49 AM
Addresses	Shipping Address	Delete	Recertification	WASHINGTON UNIVERSITY IN ST LOUIS SCHOOL OF MEDICINE INFECTIOUS DISEASES PHARMACY 620 S TAYLOR AVE RM 202 SAINT LOUIS, MO 63110-1035		5/9/2024 8:49 AM
Addresses	Shipping Address	Delete	Recertification	WASHINGTON UNIVERSITY IN ST LOUIS VILLAGE SQUARE PHARMACY 1 VILLAGE SQ SHOPPING CTR STE 1 ROOM 103 HAZELWOOD, MO 63042-1817		5/9/2024 8:49 AM
Addresses	Shipping Address	Insert	Recertification		WASH U SCHOOL OF MEDICINE - INFECTIOUS DISEASES PHARMACY 620 S TAYLOR AVE ROOM 202 SAINT LOUIS, MO 63110	5/9/2024 8:49 AM
Addresses	Shipping Address	Insert	Recertification		WASH U - VILLAGE SQUARE PHARMACY 1 VILLAGE SQUARE SHOPPING STE 1 RM 103 HAZELWOOD, MO 63042	5/9/2024 8:49 AM
Details	Nature of Support: Support Received From Date	Update	Recertification	1/1/2020 12:00:00 AM	9/30/2023 12:00:00 AM	5/9/2024 8:49 AM
Details	Nature of Support: Support Received To Date	Update	Recertification	12/31/2023 12:00:00 AM		5/9/2024 8:49 AM
Details	Last Recertification Date	Update	Recertification	5/10/2023 9:54:16 AM	5/9/2024 8:49:26 AM	5/9/2024 8:49 AM
Details	Grant Number	Update	Recertification	NU62PS924577	NH25PS005235	5/9/2024 8:49 AM
Details	NOFO Number	Update	Recertification	PS18-1802	CDC-RFA-PS-23-0011	5/9/2024 8:49 AM
Details	Last Recertification Date	Update	Recertification		5/10/2023 9:54:16 AM	5/10/2023 9:54 AM
Addresses	Main Address	Update	Change Request	1 Village Square Suite 1 Hazelwood, MO 63042	1 Village Square Suite 1 Hazelwood, MO 63042-1817	2/1/2023 5:29 PM
Addresses	Billing Address	Update	Change Request	Washington University in St. Louis Infectious Diseases Clinic North County 660 S. Euclid Campus Box 8051 Saint Louis, MO 63110	WASHINGTON UNIVERSITY IN ST LOUIS INFECTIOUS DISEASES CLINIC NORTH COUNTY 660 S EUCLID CAMPUS BOX 8051 SAINT LOUIS, MO 63110-1010	2/1/2023 5:29 PM
Addresses	Shipping Address	Insert	Change Request		WASHINGTON UNIVERSITY IN ST LOUIS SCHOOL OF MEDICINE INFECTIOUS DISEASES PHARMACY 620 S TAYLOR AVE RM 202 SAINT LOUIS, MO 63110-1035	1/5/2023 4:04 PM
Addresses	Shipping Address	Insert	Change Request		WASHINGTON UNIVERSITY IN ST LOUIS VILLAGE SQUARE PHARMACY 1 VILLAGE SQ SHOPPING CTR STE 1 ROOM 103 HAZELWOOD, MO 63042-1817	1/5/2023 4:04 PM
Details	State	Update		Approved	Active	1/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Markovich, Tina M Program Director Washington University School of Medicine 3147473071	11/17/2022 4:25 PM
Details	340B ID	Update	New Registration		STD63042	11/17/2022 4:25 PM
Dates	Participating Approval Date	Update	New Registration		11/17/2022 4:25:21 PM	11/17/2022 4:25 PM
Details	State	Update	New Registration	Pending	Approved	11/17/2022 4:25 PM
Dates	Signed By Date	Update	New Registration		10/15/2022 11:37:07 AM	11/17/2022 4:25 PM
Dates	Start Date	Update	New Registration		1/1/2023 12:00:00 AM	11/17/2022 4:25 PM
Addresses	Main Address	Insert	New Registration		1 Village Square Suite 1 Hazelwood, MO 63042	10/14/2022 5:55 PM
Addresses	Billing Address	Insert	New Registration		Washington University in St. Louis Infectious Diseases Clinic North County 660 S. Euclid Campus Box 8051 Saint Louis, MO 63110	10/14/2022 5:55 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration			10/14/2022 5:55 PM
Details	Nature Of Support	Insert	New Registration		Direct Funding (dollars received from CDC or an intermediate organization)	10/14/2022 5:55 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		1/1/2020 12:00:00 AM	10/14/2022 5:55 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration		12/31/2023 12:00:00 AM	10/14/2022 5:55 PM
Contacts	Authorizing Official	Insert	New Registration		Markovich, Tina M Program Director Washington University School of Medicine 3147473071	10/14/2022 5:55 PM
Contacts	Primary Contact	Insert	New Registration		Lengerman, Megan Clare 340B Project Manager Washington University ID Clinic 3143627595	10/14/2022 5:55 PM
Details	Assistance Received From Date	Insert	New Registration			10/14/2022 5:55 PM
Details	Assistance Received To Date	Insert	New Registration			10/14/2022 5:55 PM
Details	Last Recertification Date	Insert	New Registration			10/14/2022 5:55 PM
Details	Grant Number	Insert	New Registration		NU62PS924577	10/14/2022 5:55 PM
Details	340B ID	Insert	New Registration			10/14/2022 5:55 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/14/2022 5:55 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/14/2022 5:55 PM
Details	Medicare Provider Number	Insert	New Registration			10/14/2022 5:55 PM
Details	Entity Name	Insert	New Registration		WASHINGTON UNIVERSITY IN ST. LOUIS	10/14/2022 5:55 PM
Details	NOFO Number	Insert	New Registration		PS18-1802	10/14/2022 5:55 PM
Details	Program Code	Insert	New Registration		STD	10/14/2022 5:55 PM
Details	Entity Subname	Insert	New Registration		Washington University Infectious Diseases Clinic North County	10/14/2022 5:55 PM
Dates	Participating Approval Date	Insert	New Registration			10/14/2022 5:55 PM
Details	State	Insert	New Registration		Pending	10/14/2022 5:55 PM
Dates	Registration Date	Insert	New Registration		10/14/2022 5:55:03 PM	10/14/2022 5:55 PM
Dates	Signed By Date	Insert	New Registration			10/14/2022 5:55 PM
Dates	Start Date	Insert	New Registration			10/14/2022 5:55 PM
Terminations	Termination Comments	Insert	New Registration			10/14/2022 5:55 PM
Terminations	Termination Date	Insert	New Registration			10/14/2022 5:55 PM
Terminations	Termination Effective Date	Insert	New Registration			10/14/2022 5:55 PM
Terminations	Termination Reason	Insert	New Registration			10/14/2022 5:55 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History