340B Drug Pricing Program Database

Pharmacy Name

WESTERN WISCONSIN HEALTH- HEALTHSHOP PHA

Pharmacy Address

1100 BERGSLIEN ST
BALDWIN, WI 54002-2600

Pharmacy Comments

Approval Date

10/12/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Alison Page, Chief Executive Officer
(715) 684-1100

Contract Pharmacy Representative

Baldwin Area Medical Center
James C Korson, Pharmacy manager
(715) 684-1401

Signed By Date

10/12/2021