Contract Pharmacy Details

CVS PHARMACY, INC.
RWI78752 Vivent Health Texas, Inc.

Covered Entity Details

Entity Name

Vivent Health Texas, Inc.

Subdivision Name

AIDS Services of Austin

Type

Ryan White Part A

340B ID

RWI78752

Entity Address

104 E Highland Mall Blvd
Suite 100
Austin, TX 78752

Grant Number

H89HA00036

Participating Start Date

10/1/2018

Last Recertification Date

2/23/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA: CVS/PHARMACY # 00213
5526 S. CONGRESS AVE.
AUSTIN, TX 78745

Pharmacy Comments

Contract Details

Approval Date

10/15/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/23/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul Scott, C.E.O.
(512) 458-2437

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/15/2018

340B Drug Pricing Program Database