Covered Entity Details

DSH160082BX IOWA METHODIST MEDICAL CENTER (Active) - information as of 5/3/2025 11:33:08 PM

Main Details

Name

IOWA METHODIST MEDICAL CENTER

Subdivision Name

Central Iowa Hospital Corporation - UnityPoint Health - Des Moines Medication Therapy Management - 2023300

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH160082BX

Medicare Provider Number

160082

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/7/2022

Participating Start Date

10/1/2022

Participating Approval Date

8/3/2022

Last Recertification Date

8/23/2024

Contacts

Authorizing Official

UnityPoint Health - Des Moines
Jon Rozenfeld, Market President
(515) 241-6396

Primary Contact

UnityPoint Health Des Moines
Brian D. Benson, Executive Director of Pharmacy
(515) 241-3411

Addresses

Street Address

1212 Pleasant Street
Suite 109
Des Moines, IA 50309

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
IA	06-00825	1396837951

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH160082A	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION /Maternity Unit -West - 3015000	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082AA	Child	DSH	IOWA METHODIST MEDICAL CENTER	Infusion Center - Infusion Center - Meth - 2024000	1221 Pleasant Street	Des Moines	IA	Active
DSH160082AB	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Recovery - Ambulatory Surgery - 1020100	700 East University Avenue	Des Moines	IA	Active
DSH160082AC	Child	DSH	IOWA METHODIST MEDICAL CENTER	Blank Children's Infusion Center - BIC - 2024010	1215 Pleasant Street	Des Moines	IA	Active
DSH160082AD	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Psychiatric Services - 1012300	700 East University Avenue	Des Moines	IA	Terminated
DSH160082AE	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Cardiac Rehabilitation - 1034200	700 East University Avenue	Des Moines	IA	Active
DSH160082AF	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Renal Dialysis - 1026100	700 East University Avenue	Des Moines	IA	Active
DSH160082AG	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Access Center - ED - 1031600	700 East University Avenue	Des Moines	IA	Active
DSH160082AH	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Vascular Lab - 1022600	700 East University Avenue	Des Moines	IA	Active
DSH160082AJ	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Mammography -Luth - 1022700	700 East University Avenue	Des Moines	IA	Active
DSH160082AK	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Nuclear Medicine - Luth - 1022400	700 East University Avenue	Des Moines	IA	Active
DSH160082AL	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Outpt Pediatric MH - Luth - 1031200	700 East University Avenue	Des Moines	IA	Active
DSH160082AM	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Ambulatory Surgery - 1020120	700 East University Avenue	Des Moines	IA	Terminated
DSH160082AN	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - CT Scan - 1022100	700 East University Avenue	Des Moines	IA	Active
DSH160082AP	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Respiratory Care - LUTH - 1035000	700 East University Avenue	Des Moines	IA	Active
DSH160082AQ	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - ILH Therapy OP - 1028310	700 East University Avenue	Des Moines	IA	Active
DSH160082AR	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Echocardiography - Luth - 1034010	700 East University Avenue	Des Moines	IA	Active
DSH160082AS	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital -Surgery - LUTH - 1020000	700 East University Avenue	Des Moines	IA	Active
DSH160082AT	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Radiology - 1022200	700 East University Avenue	Des Moines	IA	Active
DSH160082AU	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Emergency Department - Luth - 1033000	700 East University Avenue	Des Moines	IA	Active
DSH160082AV	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Cardiac Cath Lab - 1034100	700 East University Avenue	Des Moines	IA	Active
DSH160082AW	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Infusion Center- Luth - 1024000	700 East University Avenue	Des Moines	IA	Active
DSH160082AX	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Adult Partial Hospitalization - 1031430	700 East University Avenue	Des Moines	IA	Active
DSH160082AY	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - ILH Therapy - 1028300	700 East University Avenue	Des Moines	IA	Active
DSH160082AZ	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Endoscopy - Luth - 1020400	700 East University Avenue	Des Moines	IA	Active
DSH160082B	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Methodist West Hospital - Emergency 3033000	1660 60TH Street	WEST DES MOINES	IA	Active
DSH160082BA	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - MRI - Luth - 1022300	700 East University Avenue	Des Moines	IA	Active
DSH160082BB	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Recovery Room PACU LUTH - 1020200	700 East University Avenue	Des Moines	IA	Active
DSH160082BC	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - EKG-LUTH - 1034000	700 East University Avenue	Des Moines	IA	Active
DSH160082BD	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Electroencephalography - 1032000	700 East University Avenue	Des Moines	IA	Active
DSH160082BE	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - ECT - 1031710	700 East University Avenue	Des Moines	IA	Active
DSH160082BF	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Powell CDC - 1031000	700 East University Avenue	Des Moines	IA	Active
DSH160082BG	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - Blank Pediatric Gastroenterology 2043400	1215 PLEASANT STREET	DES MOINES	IA	Active
DSH160082BH	Child	DSH	IOWA METHODIST MEDICAL CENTER	UNITYPOINT HEALTH - DES MOINES BLAN - Blank Pediatric Pulmonology 2043100	1212 PLEASANT STREET	DES MOINES	IA	Active
DSH160082BJ	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - Blank Pediatric Endocrinology - 2043600	1215 Pleasant Street	Des Moines	IA	Active
DSH160082BK	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines - Cardiology - Lakeview 2043010	6000 UNIVERSITY AVENUE	WEST DES MOINES	IA	Active
DSH160082BL	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines - Cardiology and Cardiac Arrythmia - Plaza 2043000	1215 PLEASANT STREET	DES MOINES	IA	Active
DSH160082BM	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines Infectious Disease - Plaza 2043900	1221 PLEASANT STREET	DES MOINES	IA	Active
DSH160082BN	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines - Neurology - Plaza 2043200	1221 PLEASANT ST STE 300	DES MOINES	IA	Active
DSH160082BP	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines - Cardiology - Penn Ave 1043000	1301 PENNSYLVANIA AVENUE	DES MOINES	IA	Active
DSH160082BQ	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines - Neurology - Lakeview 2043200	6000 UNIVERSITY AVENUE	WEST DES MOINES	IA	Active
DSH160082BR	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health - Des Moines Blank Children's Pediatrics - 2041500	1212 PLEASANT ST STE 300	DES MOINES	IA	Active
DSH160082BS	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORP - UnityPoint Health - Des Moines Blank Children's Psychiatry - 2044700	1206 PLEASANT ST	DES MOINES	IA	Active
DSH160082BT	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health - Des Moines Blank Children's Diagnostics - 2043920	1212 PLEASANT ST STE 300	DES MOINES	IA	Active
DSH160082BU	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health - Des Moines Blank Children's Palliative Care - 2038320	1212 PLEASANT ST STE 300	DES MOINES	IA	Active
DSH160082BV	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health - Des Moines Blank Children's Orthopaedics - 2042410	1215 PLEASANT STREET	DES MOINES	IA	Active
DSH160082BW	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - UnityPoint Health Des Moines Blank Children's Neurology 2043210	1215 PLEASANT ST STE 303	DES MOINES	IA	Active
DSH160082BX	Child	DSH	IOWA METHODIST MEDICAL CENTER	Central Iowa Hospital Corporation - UnityPoint Health - Des Moines Medication Therapy Management - 2023300	1212 Pleasant Street	Des Moines	IA	Active
DSH160082BY	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - Counseling and Psychiatry - Lakeview 3044500	6000 UNIVERSITY AVE STE 200	WEST DES MOINES	IA	Active
DSH160082BZ	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION - Behavioral Health Urgent Care - 1044620	1250 E 9TH ST	DES MOINES	IA	Active
DSH160082C	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION /Surgery-West 3020000	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082CA	Child	DSH	IOWA METHODIST MEDICAL CENTER	UNITYPOINT HEALTH - DES MOINES BLAN - Children's Treatment/Surgery Room - 2020920	1206 PLEASANT ST	DES MOINES	IA	Active
DSH160082D	Child	DSH	IOWA METHODIST MEDICAL CENTER	IOWA METHODIST HAND CLINIC	6001 WESTOWN PKWY #101	WEST DES MOINES	IA	Terminated
DSH160082E	Child	DSH	IOWA METHODIST MEDICAL CENTER	JOHN STODDARD CANCER CENTER - 2027030	1221 PLEASANT STREET	DES MOINES	IA	Active
DSH160082F	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Eye Surgery Center - 2020110	1300 37TH STREET	WEST DES MOINES	IA	Active
DSH160082G	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Wound Healing Center	1215 PLEASANT ST	DES MOINES	IA	Terminated
DSH160082H	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / EEG-West - 3032000	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082J	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Echocardiography - West 3034010	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082K	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Therapy Services MWH - West 3028300	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082L	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / EKG-West 3034000	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082M	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION /Respiratory Care-West 3035000	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082N	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Methodist West Hospital - Blood Bank	1660 60TH ST	WEST DES MOINES	IA	Terminated
DSH160082P	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Methodist West Hospital - Laboratory	1660 60TH ST	WEST DES MOINES	IA	Terminated
DSH160082Q	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / MRI - West 3022300	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082R	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / CT SCAN -WEST 3022100	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082S	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Ultrasound - West 3022500	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082T	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Nuclear Medicine West - 3022400	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082U	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION /General Radiology - West 3022200	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082V	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / PACU - West - 3020200	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082W	Child	DSH	IOWA METHODIST MEDICAL CENTER	CENTRAL IOWA HOSPITAL CORPORATION / Surgery -West 3020000	1660 60TH STREET	WEST DES MOINES	IA	Active
DSH160082X	Child	DSH	IOWA METHODIST MEDICAL CENTER	Central Iowa Hospital Corporation/ Orthopedics 3-West 3010610	1660 60th Street	West Des Moines	IA	Active
DSH160082Y	Child	DSH	IOWA METHODIST MEDICAL CENTER	Central Iowa Hospital Corporation/ Med/Surg 4- West 3010710	1660 60th Street	West Des Moines	IA	Active
DSH160082Z	Child	DSH	IOWA METHODIST MEDICAL CENTER	Iowa Lutheran Hospital - Ultrasound - Luth- 1022500	700 East University Avenue	Des Moines	IA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Change Request	Jaeger, Paige L Vice President, Operations UnityPoint Health Des Moines 5152414422	Rozenfeld, Jon Market President UnityPoint Health - Des Moines 5152416396	3/25/2025 7:28 AM
Contacts	Authorizing Official	Update	Change Request	Mulrooney, Thomas P Chief Operating Officer UnityPoint Health 5152414027	Jaeger, Paige L Vice President, Operations UnityPoint Health Des Moines 5152414422	1/2/2025 3:36 PM
Details	Last Recertification Date	Update	Recertification	8/14/2023 11:41:14 AM	8/23/2024 7:12:38 AM	8/23/2024 7:12 AM
Details	Last Recertification Date	Update	Recertification		8/14/2023 11:41:14 AM	8/14/2023 11:41 AM
Contacts	Authorizing Official	Update	Change Request	Lothe, Eric SVP/COO UnityPoint Des Moines 5152415858	Mulrooney, Thomas P Chief Operating Officer UnityPoint Health 5152414027	12/13/2022 11:19 AM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Lothe, Eric SVP/COO UnityPoint Des Moines 5152415858	8/3/2022 2:58 PM
Details	340B ID	Update	New Registration		DSH160082BX	8/3/2022 2:58 PM
Details	Entity Subname	Update	New Registration	Central Iowa Hospital Corporation	Central Iowa Hospital Corporation - UnityPoint Health - Des Moines Medication Therapy Management - 2023300	8/3/2022 2:58 PM
Dates	Participating Approval Date	Update	New Registration		8/3/2022 2:58:10 PM	8/3/2022 2:58 PM
Details	State	Update	New Registration	Pending	Approved	8/3/2022 2:58 PM
Dates	Signed By Date	Update	New Registration		8/1/2022 10:36:11 AM	8/3/2022 2:58 PM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	8/3/2022 2:58 PM
Addresses	Main Address	Insert	New Registration		1212 Pleasant Street Suite 109 Des Moines, IA 50309	7/7/2022 3:44 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/7/2022 3:44 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		06-00825	7/7/2022 3:44 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		IA	7/7/2022 3:44 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1396837951	7/7/2022 3:44 PM
Medicaid Billing	NPI: State	Insert	New Registration		IA	7/7/2022 3:44 PM
Contacts	Authorizing Official	Insert	New Registration		Lothe, Eric SVP/COO UnityPoint Des Moines 5152415858	7/7/2022 3:44 PM
Contacts	Primary Contact	Insert	New Registration		Benson, Brian D. Executive Director of Pharmacy UnityPoint Health Des Moines 5152413411	7/7/2022 3:44 PM
Details	Assistance Received From Date	Insert	New Registration			7/7/2022 3:44 PM
Details	Assistance Received To Date	Insert	New Registration			7/7/2022 3:44 PM
Details	Last Recertification Date	Insert	New Registration			7/7/2022 3:44 PM
Details	Grant Number	Insert	New Registration			7/7/2022 3:44 PM
Details	340B ID	Insert	New Registration			7/7/2022 3:44 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/7/2022 3:44 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/7/2022 3:44 PM
Details	Medicare Provider Number	Insert	New Registration		160082	7/7/2022 3:44 PM
Details	Entity Name	Insert	New Registration		IOWA METHODIST MEDICAL CENTER	7/7/2022 3:44 PM
Details	NOFO Number	Insert	New Registration			7/7/2022 3:44 PM
Details	Program Code	Insert	New Registration		DSH	7/7/2022 3:44 PM
Details	Entity Subname	Insert	New Registration		Central Iowa Hospital Corporation	7/7/2022 3:44 PM
Dates	Participating Approval Date	Insert	New Registration			7/7/2022 3:44 PM
Details	State	Insert	New Registration		Pending	7/7/2022 3:44 PM
Dates	Registration Date	Insert	New Registration		7/7/2022 3:44:20 PM	7/7/2022 3:44 PM
Dates	Signed By Date	Insert	New Registration			7/7/2022 3:44 PM
Dates	Start Date	Insert	New Registration			7/7/2022 3:44 PM
Terminations	Termination Comments	Insert	New Registration			7/7/2022 3:44 PM
Terminations	Termination Date	Insert	New Registration			7/7/2022 3:44 PM
Terminations	Termination Effective Date	Insert	New Registration			7/7/2022 3:44 PM
Terminations	Termination Reason	Insert	New Registration			7/7/2022 3:44 PM