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DSH160083L CATHOLIC HEALTH INITIATIVES - IOWA, CORP (Active)
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Main Details
Name
CATHOLIC HEALTH INITIATIVES - IOWA, CORP
Subdivision Name
MercyOne Des Moines Outpatient Cardiac Testing
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160083L
Medicare Provider Number
160083
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/3/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/15/2011
Last Recertification Date
9/4/2024
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
411 Laurel St
Suite A250
DES MOINES, IA 50314
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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