340B Drug Pricing Program Database
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DSH160110H Allen Memorial Hospital Corporation (Active)
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Main Details
Name
Allen Memorial Hospital Corporation
Subdivision Name
Medication Management - UMP - Medication Management
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160110H
Medicare Provider Number
160110
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/15/2023
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Allen Memorial Hospital Corporation
Jennifer A Friedly, President
(319) 235-3997
Primary Contact
Allen Memorial Hospital Corporation
Natalie Arlene Hunter, VP Operations
(319) 235-3660
Addresses
Street Address
1731 W Ridgeway
500
Waterloo, IA 50701-4594
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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