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NUCARA SPECIALTY PHARMACY
STD501581 Primary Health Care
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Covered Entity Details
Entity Name
Primary Health Care
Subdivision Name
Marshalltown Medical Clinic
Type
Sexually Transmitted Diseases
340B ID
STD501581
Entity Address
101 Iowa Ave W
102
Marshalltown, IA 50158
Grant Number
NH25PS005158
Participating Start Date
4/1/2017
Last Recertification Date
5/8/2024
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
10/2/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly Huntsman, CEO
(515) 248-1441
Contract Pharmacy Representative
NuCara Pharmacy
Jeff Mullen, Director
(515) 266-4167
Signed By Date
10/2/2023
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