340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH160067CK MercyOne Waterloo Medical Center (Terminated)
Print
Main Details
Name
MercyOne Waterloo Medical Center
Subdivision Name
MercyOne Allison Family Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160067CK
Medicare Provider Number
160067
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/7/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/8/2019
Last Recertification Date
9/13/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
MercyOne NorthEast Iowa
Timothy Huber, Vice President of Finance
(319) 272-7607
Primary Contact
MercyOne Northeast Iowa
Trish Means Neuroth, Reimbursement Accountant
(319) 272-7601
Addresses
Street Address
502 Locust St
Allison, IA 50602-7738
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
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