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CARES PHARMACY
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
CARES PHARMACY
Pharmacy Address
DBA VIVENT PHARMACY
5250 LEETSDALE DR STE 300
DENVER, CO 80246-1451
Pharmacy Comments
Contract Details
Approval Date
1/10/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Cheryl Oliver, Executive Director
(314) 645-6451 Ext: 212
Contract Pharmacy Representative
AIDS Resource Center of Wisconsin, Inc.
Timothy D Dyer, CFO
(414) 225-1542
Signed By Date
1/10/2018
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