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SCH160013-00 UNITY HEALTHCARE D/B/A TRINITY MUSCATINE (Terminated)
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Main Details
Name
UNITY HEALTHCARE D/B/A TRINITY MUSCATINE
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH160013-00
Medicare Provider Number
160013
Additional Details
Current Program Status
Terminated
Registration Date
5/31/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/18/2012
Last Recertification Date
9/10/2020
Termination Date
Termination Reason
10/1/2021
DSH percentage below statutory minimum
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
1518 MULBERRY AVE
MUSCATINE, IA 52761
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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