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SCHNUCK MARKETS, INC.
RWI63110 Vivent Health
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Covered Entity Details
Entity Name
Vivent Health
Subdivision Name
Type
Ryan White Part A
340B ID
RWI63110
Entity Address
2653 Locust Street
St. Louis, MO 63103
Grant Number
H89HA00033
Participating Start Date
1/1/2016
Last Recertification Date
2/23/2025
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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