Contract Pharmacy Details

NUCARA SPECIALTY PHARMACY
RWIID503191 Iowa Department of Health and Human Services

Covered Entity Details

Entity Name

Iowa Department of Health and Human Services

Subdivision Name

RYAN WHITE PART B AIDS ADAP

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID503191

Entity Address

LUCAS STATE OFFICE BLDG
321 E. 12TH ST, 5TH FLOOR
DES MOINES, IA 50319-0075

Grant Number

X07HA00005

Participating Start Date

4/1/1998

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

NUCARA SPECIALTY PHARMACY

Pharmacy Address

NUDAK VENTURES LLC
5042 MAPLE DR
PLEASANT HILL, IA 50327-2039

Pharmacy Comments

Contract Details

Approval Date

6/10/2019

Contract Begin Date

5/20/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Randy Mayer, Chief, Bureau of HIV, STI, and Hepatitis
(515) 242-5150

Contract Pharmacy Representative

NuCara Pharmacy
Jeff Mullen, Director
(515) 266-4167

Signed By Date

6/10/2019

340B Drug Pricing Program Database