340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WISCONSIN CVS PHARMACY, L.L.C.
RRC520066-00 MERCY HEALTH SYSTEM CORPORATION
Print
Covered Entity Details
Entity Name
MERCY HEALTH SYSTEM CORPORATION
Subdivision Name
Type
Rural Referral Center
340B ID
RRC520066-00
Entity Address
1000 MINERAL POINT AVE
JANESVILLE, WI 53547-5003
Medicare Provider Number
520066
Participating Start Date
1/1/2024
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
WISCONSIN CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08763
1650 FARWELL
MILWAUKEE, WI 53202
Pharmacy Comments
Contract Details
Approval Date
12/1/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Todd Anderson, Vice President Finance
(815) 971-6738
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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