Contract Pharmacy Details

UW HEALTH
RWII53715 University of Wisconsin-Madison

Covered Entity Details

Entity Name

University of Wisconsin-Madison

Subdivision Name

UW HIV Care and Prevention Program

Type

Ryan White Part B

340B ID

RWII53715

Entity Address

600 Highland Ave.
Attn: Julie Yendrek, ID Clinic
Room B6/242
Madison, WI 53792

Grant Number

X07HA00027

Participating Start Date

4/1/2015

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

UW HEALTH

Pharmacy Address

OUTPATIENT PHARMACY
600 HIGHLAND AVE RM E5-236
MADISON, WI 53792

Pharmacy Comments

Contract Details

Approval Date

1/22/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

UW Health
Melissa Ngo, Manager-340B Operations and Support
(608) 662-2315

Signed By Date

340B Drug Pricing Program Database