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SCHNUCK MARKETS, INC.
STD63110 Vivent Health
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Covered Entity Details
Entity Name
Vivent Health
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD63110
Entity Address
2653 Locust Street
St. Louis, MO 63103
Grant Number
NH25PS005142
Participating Start Date
10/1/2015
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
SCHNUCK MARKETS, INC.
Pharmacy Address
DBA SCHNUCKS PHARMACY #304
1520 BRENTWOOD BLVD.
SAINT LOUIS, MO 63144
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Cheryl Oliver, Executive Director
(314) 645-6451 Ext: 212
Contract Pharmacy Representative
Schnuck's Pharmacy
David Chism, Director of Pharmacy
(314) 344-9636
Signed By Date
7/18/2017
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