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DSH160110D Allen Memorial Hospital Corporation (Active)
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Main Details
Name
Allen Memorial Hospital Corporation
Subdivision Name
ALLEN HOSPITAL COMMUNITY CANCER CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160110D
Medicare Provider Number
160110
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/20/2017
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
3530 W 4TH ST.
WATERLOO, IA 50701-4503
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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