Contract Pharmacy Details

SCHNUCKS PHARMACY #399
HV07849 WASHINGTON UNIVERSITY IN ST. LOUIS

Covered Entity Details

Entity Name

WASHINGTON UNIVERSITY IN ST. LOUIS

Subdivision Name

Washington University Infectious Diseases Clinic

Type

Ryan White Part C

340B ID

HV07849

Entity Address

620 S TAYLOR AVENUE
SUITE 100
SAINT LOUIS, MO 63110-1010

Grant Number

H76HA07849

Participating Start Date

4/1/2010

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

SCHNUCKS PHARMACY #399

Pharmacy Address

12921 ENTERPRISE WAY
BRIDGETON, MO 63044-1206

Pharmacy Comments

Contract Details

Approval Date

7/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/31/2020
Pharmacy closed

Contacts

Covered Entity Signing Official

Paul J Scheel, Jr, Associate Vice Chancellor for Clinical & CEO
(314) 362-6249

Contract Pharmacy Representative

Schnucks Pharmacy
Noah Tennyson, Director of Specialty Pharmacy
(314) 994-4739

Signed By Date

7/15/2019

340B Drug Pricing Program Database