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VIVENT PHARMACY LLC
HV00204 University of Wisconsin-Madison
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Covered Entity Details
Entity Name
University of Wisconsin-Madison
Subdivision Name
UW HIV Care and Prevention Program
Type
Ryan White Part C
340B ID
HV00204
Entity Address
600 Highland Ave.
Attn: Julie Yendrek, ID Clinic
Room B6/242
Madison, WI 53792
Grant Number
H76HA00204
Participating Start Date
1/1/2013
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
VIVENT PHARMACY LLC
Pharmacy Address
DBA VIVENT PHARMACY
600 WILLIAMSON ST STE H
MADISON, WI 53703
Pharmacy Comments
Contract Details
Approval Date
10/7/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael J. Kuntz, Managing Officer
(608) 262-2588
Contract Pharmacy Representative
AIDS Resource Center of Wisconsin
Daniel Guinn, VP of Compliance & General Counsel
(608) 316-8602
Signed By Date
10/7/2015
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