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DSH160057 Southeast Iowa Regional Medical Center (Active)
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Main Details
Name
Southeast Iowa Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160057
Medicare Provider Number
160057
Additional Details
Current Program Status
Active
Registration Date
1/5/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/6/2022
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Great River Health System
Jeremy Alexander, Chief Financial Officer
(319) 768-3280
Primary Contact
Southeast Iowa Regional Medical Center
Steve Frigo, Director, Pharmacy
(319) 768-3971
Addresses
Street Address
1221 SOUTH GEAR AVENUE
WEST BURLINGTON, IA 52655
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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