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HM683 Versiti Wisconsin, Inc. (Active)
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Main Details
Name
Versiti Wisconsin, Inc.
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM683
Grant Number
H30MC24052
Additional Details
Current Program Status
Active
Registration Date
1/1/1997
Participating Start Date
1/1/1997
Participating Approval Date
3/22/2005
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Versiti Wisconsin, Inc.
Bartholomew Frederick Reuter, Executive Vice President, General Counsel & Chief Compliance Officer
(414) 937-6418
Primary Contact
Versiti Wisconsin, Inc.
Joseph Bailey, Supervisor, Pharmacy Operations
(414) 937-6436
Addresses
Street Address
638 N 18TH STREET
MILWAUKEE, WI 53233
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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11/27/06 UPDATED ADDR (WAS ZIP: 53201); 11/27/06 DELETED ALTERNATE SHIP TO (WAS THE BLOOD CENTER OF SOUTHEASTERN WISCONSIN, INC., 10310A W WATERTOWN PLANK, WAUWATOSA, WI 53226); UPDATED ENTITY NAME (WAS THE BLOOD CENTER OF SOUTHEASTERN WISCONSIN, INC.)
01/01/1997
April 2025
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