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VIVENT PHARMACY LLC
CH05306AJ Sixteenth Street Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers-UCC Senior Center
Type
HRSA-Funded Health Center
340B ID
CH05306AJ
Entity Address
730 W Washington St
Milwaukee, WI 53204-2310
Grant Number
H80CS00593
Participating Start Date
7/1/2016
Last Recertification Date
2/11/2025
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
7/12/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Liz Claudio, Vice President, Operations
(414) 897-5165
Contract Pharmacy Representative
AIDS Resource Center of Wisconsin
Michael Gifford, CEO
(414) 225-1547
Signed By Date
7/12/2022
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