340B Drug Pricing Program Database
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DSH160058H UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER
Subdivision Name
Otolaryngology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160058H
Medicare Provider Number
160058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/31/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/10/2012
Last Recertification Date
8/19/2024
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
105 E 9th ST
Coralville, IA 52241
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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