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DSH160110A Allen Memorial Hospital Corporation (Active)
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Main Details
Name
Allen Memorial Hospital Corporation
Subdivision Name
Allen Hospital Pain Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160110A
Medicare Provider Number
160110
Outpatient Facility Provider Number
160110
Additional Details
Current Program Status
Active
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/5/2013
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Allen Memorial Hospital Corporation
Jennifer A Friedly, President
(319) 235-3997
Primary Contact
Allen Memorial Hospital Corporation
Natalie Arlene Hunter, VP Operations
(319) 235-3660
Addresses
Street Address
3630 West Fourth Street
Waterloo, IA 50701-4504
Billing Address
Allen Memorial Hospital
1825 Logan Ave
Waterloo, IA 50703
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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