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CAH161338-00 MercyOne Oelwein Medical Center (Active)
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Main Details
Name
MercyOne Oelwein Medical Center
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161338-00
Medicare Provider Number
161338
Additional Details
Current Program Status
Active
Registration Date
9/13/2010
Participating Start Date
9/30/2010
Participating Approval Date
9/14/2010
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
MercyOne NorthEast Iowa
Timothy Huber, Vice President of Finance
(319) 272-7607
Primary Contact
Covenant Medical Center
Jaclyn Annette Van Raden, 340B Contract Pharmacy Analyst
(319) 272-8636
Addresses
Street Address
201 8TH AVE
OELWEIN, IA 50662-2447
Billing Address
MercyOne Northeast Iowa
3421 W 9TH ST
WATERLOO, IA 50702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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07/18/11 ADDED SHIP TO ADDR( AT 201 8TH AVE)
07/18/2011
April 2025
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