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DSH160083BE CATHOLIC HEALTH INITIATIVES - IOWA, CORP (Active)
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Main Details
Name
CATHOLIC HEALTH INITIATIVES - IOWA, CORP
Subdivision Name
Mercyone Des Moines Cancer & Infusion Care - Newton - Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160083BE
Medicare Provider Number
160083
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/27/2025
Last Recertification Date
Contacts
Authorizing Official
MercyOne
Terri Jane Donovan, Interim Chief Financial Officer
(515) 643-8212
Primary Contact
MercyOne
Jennifer Lynn Egbert, Market Director of Pharmacy
(304) 730-5888
Addresses
Street Address
204 N 4th Ave E
Suite 131
Newton, IA 50208
Billing Address
Mercy Medical Center -Des Moines
1111 6th Ave
Des Moines, IA 50314
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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