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HV00621A Vivent Health (Active)
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Main Details
Name
Vivent Health
Subdivision Name
Type
Ryan White Part C
340B ID
HV00621A
Grant Number
H76HA00621
Additional Details
Current Program Status
Active
Registration Date
10/12/2012
Participating Start Date
1/1/2013
Participating Approval Date
12/17/2012
Last Recertification Date
2/23/2025
Time Period the Assistance was Received
5/1/2023 - 4/30/2025
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
1212 57TH STREET
KENOSHA, WI 53140
Billing Address
Vivent Health
1311 N 6th Street
Milwaukee, WI 53212
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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11/8/12 - Reviewed application and sent email to PO for verification.
11/08/2012
April 2025
April 2025
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