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UW HEALTH PHARMACY SERVICES
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.
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
UW HEALTH PHARMACY SERVICES
Pharmacy Address
3185 DEMING WAY
MIDDLETON, WI 53562
Pharmacy Comments
Contract Details
Approval Date
10/5/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathleen Sielaff, Managing Officer
(608) 890-2904
Contract Pharmacy Representative
UW Health
Melissa Ngo, Manager-340B Operations and Support
(608) 662-2315
Signed By Date
10/5/2017
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