340B Drug Pricing Program Database
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DSH140280Y TRINITY ROCK ISLAND (Active)
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Main Details
Name
TRINITY ROCK ISLAND
Subdivision Name
UnityPoint Health Trinity Rock Island Multi Specialty Clinic - Pulmonology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140280Y
Medicare Provider Number
140280
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/23/2024
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
UnityPoint-Trinity
Dave Dellitt, Chief Financial Officer
(309) 779-2218
Primary Contact
UnityPoint - Trinity
Jaime Graves, 340B Pharmacy Coordinator
(309) 779-5030
Addresses
Street Address
2560 24th Street
102
Rock Island, IL 61201
Billing Address
Trinity Rock Island
2701 17th Street
Rock Island, IL 61201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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