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DSH160083AF CATHOLIC HEALTH INITIATIVES - IOWA, CORP (Terminated)
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Main Details
Name
CATHOLIC HEALTH INITIATIVES - IOWA, CORP
Subdivision Name
MERCYONE DES MOINES INTERNAL MED - Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160083AF
Medicare Provider Number
160083
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
5/27/2021
Participating Start Date
6/8/2021
Participating Approval Date
6/8/2021
Last Recertification Date
9/7/2022
Termination Date
Termination Reason
4/1/2023
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Catholic Health Initiatives, Iowa Corp.
Randall Rubin, Senior Vice President Chief Financial Officer
(515) 643-2860
Primary Contact
Catholic Health Initiatives, Iowa Corp
Kevin McVey, interim PIC
(515) 643-2934
Addresses
Street Address
411 LAUREL ST
STE 2310
DES MOINES, IA 50314-3005
Billing Address
Catholic Health Initiatives
PO Box 636000
Littleton, CO 80163-6000
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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