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DSH160058CX UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER (Approved)
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Main Details
Name
UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER
Subdivision Name
UNIVERSITY OF IOWA HEALTH CARE - JEFFERSON STREET MED INFECTIOUS DISEASE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160058CX
Medicare Provider Number
160058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/14/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/8/2025
Last Recertification Date
Contacts
Authorizing Official
University of Iowa Health Care
Michael Brownlee, Chief Pharmacy Officer
(319) 384-9371
Primary Contact
University of Iowa Health Care
Becky Marie Triplett, Manager, 340B and Compliance
(319) 384-5583
Addresses
Street Address
540 E. JEFFERSON ST.
STE 306
IOWA CITY, IA 52245
Billing Address
University of Iowa Accounts Payable
202 PCO
Iowa City, IA 52242
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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