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DSH160024B IOWA LUTHERAN HOSPITAL (Terminated)
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Main Details
Name
IOWA LUTHERAN HOSPITAL
Subdivision Name
Blank Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160024B
Medicare Provider Number
160024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/25/2013
Last Recertification Date
8/31/2018
Termination Date
Termination Reason
10/1/2019
Other
Contacts
Authorizing Official
UnityPoint Des Moines
Eric Lothe, SVP/COO
(515) 241-5858
Primary Contact
UnityPoint Health Des Moines
Brian D. Benson, Executive Director of Pharmacy
(515) 241-3411
Addresses
Street Address
1215 Pleasant Street
Suite 500
Des Moines, IA 50309
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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