340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PICK N SAVE PHARMACY #6864
UI020 GERALD L IGNACE INDIAN HEALTH CENTER, INC.
Print
Covered Entity Details
Entity Name
GERALD L IGNACE INDIAN HEALTH CENTER, INC.
Subdivision Name
Type
Urban Indian
340B ID
UI020
Entity Address
930 West Historic Mitchell Street
MILWAUKEE, WI 53204
Grant Number
Participating Start Date
7/1/2006
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PICK N SAVE PHARMACY #6864
Pharmacy Address
1818 W NATIONAL AVE
MILWAUKEE, WI 53204
Pharmacy Comments
Contract Details
Approval Date
4/2/2008
Contract Begin Date
4/2/2008
Carve-In Effective Date
Contract Comments
12/18/2009 - PHARMACY NAME CHANGED FROM AURORA PHARMACY #197. AURORA WAS PURCHASED BY ROUNDY'S (PICK N SAVE). RECEIVED UPDATED SELF-CERT FORM DATED 5/27. SIGNED BY INFORMATION REMAINED THE SAME.
Contract Termination Date
Termination Reason
8/1/2017
Pharmacy closed
Contacts
Covered Entity Signing Official
PRADEEP G. KUMAR, MEDICAL DIRECTOR
(414) 383-9526
Contract Pharmacy Representative
Signed By Date
1/26/2010
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session