340B Drug Pricing Program Database
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RWI55114 SAYFSM (Active)
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Main Details
Name
SAYFSM
Subdivision Name
Type
Ryan White Part A
340B ID
RWI55114
Grant Number
H89HA00050
Additional Details
Current Program Status
Active
Registration Date
4/5/2022
Participating Start Date
7/1/2022
Participating Approval Date
6/14/2022
Last Recertification Date
3/3/2025
Time Period the Assistance was Received
3/1/2025 - 2/28/2026
Contacts
Authorizing Official
SAYFSM
Ephraim Olani, Ex. Director
(651) 644-3983 Ext: 6516443983
Primary Contact
SAYFSM
Gari Negeri Jaleta, Medical Case Manager
(651) 644-3983
Addresses
Street Address
2395 University Ave. #200
St. Paul, MN 55114
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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May 2025
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