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PICK N SAVE PHARMACY #6864
CH053060 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-Chavez
Type
HRSA-Funded Health Center
340B ID
CH053060
Entity Address
1032 S Cesar E Chavez Dr
MILWAUKEE, WI 53204
Grant Number
H80CS00593
Participating Start Date
10/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PICK N SAVE PHARMACY #6864
Pharmacy Address
1818 W NATIONAL AVE
MILWAUKEE, WI 53204
Pharmacy Comments
Contract Details
Approval Date
12/1/1996
Contract Begin Date
12/1/1996
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).
Contract Termination Date
Termination Reason
7/26/2016
Pharmacy closed
Contacts
Covered Entity Signing Official
Betsy Spahiu, Vice President Finance
(414) 897-5153
Contract Pharmacy Representative
Signed By Date
12/17/2009
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