340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
VIVENT PHARMACY LLC
STD532162 AIDS Resource Center of Wisconsin
Print
Covered Entity Details
Entity Name
AIDS Resource Center of Wisconsin
Subdivision Name
Vivent Health - Keenan Clinic
Type
Sexually Transmitted Diseases
340B ID
STD532162
Entity Address
3200 N 36th Street
Milwaukee, WI 53216
Grant Number
5H25PS004336-03
Participating Start Date
1/1/2019
Last Recertification Date
5/26/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
VIVENT PHARMACY LLC
Pharmacy Address
DBA VIVENT PHARMACY
1311 N 6TH ST STE 101
MILWAUKEE, WI 53212
Pharmacy Comments
Contract Details
Approval Date
11/20/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Timothy D Dyer, CFO
(414) 225-1542
Contract Pharmacy Representative
ARCW Pharmacy
Jason Jenders, Director of Pharmacy
(414) 223-6820
Signed By Date
10/13/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session