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DSH160083AG CATHOLIC HEALTH INITIATIVES - IOWA, CORP (Active)
Main Details
Name
CATHOLIC HEALTH INITIATIVES - IOWA, CORP
Subdivision Name
MERCYONE DES MOINES DIABETES AND EN - Diabetes and Endocrinology Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH160083AG
Medicare Provider Number
160083
Outpatient Facility Provider Number
Contacts
Authorizing Official
MercyOne
Terri Jane Donovan, Interim Chief Financial Officer
(515) 643-8212
Primary Contact
Catholic Health Initiatives
Kevin Patrick McVey, Interim Director of Pharmacy
(515) 643-2934
Additional Details
Current Program Status
Active
Registration Date
5/27/2021
Participating Start Date
6/8/2021
Participating Approval Date
6/8/2021
Last Recertification Date
8/25/2023
Addresses
Street Address
411 LAUREL ST SUITE 3262
DES MOINES, IA 50314-3027
Billing Address
Catholic Health Initiatives
PO Box 63600
Littleton, CO 80163-6000
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2024
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