340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH160064H MercyOne North Iowa Medical Center (Terminated)
Print
Main Details
Name
MercyOne North Iowa Medical Center
Subdivision Name
MercyOne Sheffield Family Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160064H
Medicare Provider Number
160064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/26/2019
Last Recertification Date
8/19/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
MercyOne North Iowa Medical Center
Mark Trammel, HM VP Finance
(641) 428-7984
Primary Contact
MercyOne North Iowa Medical Center
Erin Brownmiller, 340B Program Manager
(641) 428-7024
Addresses
Street Address
203 S Second Street
Sheffield, IA 50475-5008
Billing Address
MercyOne North Iowa Medical Center
1000 4th Street SW
Mason City, IA 50401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Participating from effective date: (1/1/2017), until terminated effective date: (10/1/2018), reinstatement effective date: (10/01/2019)
07/25/2019
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session