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DSH160058P UNIVERSITY OF IOWA HOSPITALS & CLINICS (Terminated)
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Main Details
Name
UNIVERSITY OF IOWA HOSPITALS & CLINICS
Subdivision Name
Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160058P
Medicare Provider Number
160058
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/31/2012
Last Recertification Date
9/6/2018
Termination Date
Termination Reason
4/1/2019
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
University of Iowa Health Care
Michael Brownlee, Chief Pharmacy Officer
(319) 384-9371
Primary Contact
University of Iowa Hospitals & Clinics
Trisha Smith, Director, Business & Support
(319) 356-2577
Addresses
Street Address
105 E 9th Street
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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