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UW HEALTH PHARMACY SERVICES
CH0515200 Access Community Health Centers, Inc
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Covered Entity Details
Entity Name
Access Community Health Centers, Inc
Subdivision Name
Joyce & Marshall Erdman Clinic
Type
HRSA-Funded Health Center
340B ID
CH0515200
Entity Address
2202 S Park St
Madison, WI 53713-1916
Grant Number
H80CS00280
Participating Start Date
1/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
UW HEALTH PHARMACY SERVICES
Pharmacy Address
3434 EAST WASHINGTON AVE
MADISON, WI 53704
Pharmacy Comments
Contract Details
Approval Date
1/13/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ken Loving, CEO
(608) 443-5590
Contract Pharmacy Representative
UW Health
Brock Dantuma, Pharmacy Manager
(608) 263-1290
Signed By Date
1/13/2014
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