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DSH160080C MERCY MEDICAL CENTER-CLINTON INC D/B/A MercyOne Clinton Medical Center (Active)
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Main Details
Name
MERCY MEDICAL CENTER-CLINTON INC D/B/A MercyOne Clinton Medical Center
Subdivision Name
MERCYONE CLINTON MED CTR HLTH PLAZA - Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160080C
Medicare Provider Number
160080
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/2/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/9/2023
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
MercyOne Clinton Medical Center
Mellissa Wood, COO/CNE
(563) 244-5608
Primary Contact
MercyOne North Iowa Medical Center
Erin Brownmiller, 340B Program Manager
(641) 428-7024
Addresses
Street Address
600 14TH AVE N
CLINTON, IA 52732-2914
Billing Address
MercyOne Clinton Medical Center
1410 North 4th Street
Clinton, IA 52732
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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