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CRITICAL CARE SYSTEMS, LLC
DSH280013 THE NEBRASKA MEDICAL CENTER
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Covered Entity Details
Entity Name
THE NEBRASKA MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH280013
Entity Address
989200 Nebraska Medical Center
Omaha, NE 68198
Medicare Provider Number
280013
Participating Start Date
12/1/1992
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
CRITICAL CARE SYSTEMS, LLC
Pharmacy Address
D/B/A OPTION CARE
11372 AURORA AVENUE
URBANDALE, IA 50322
Pharmacy Comments
Contract Details
Approval Date
7/18/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/16/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stephanie Daubert, CFO
(402) 552-2889
Contract Pharmacy Representative
Kevin Sykes, Regional Sales Director
(618) 830-0197
Signed By Date
7/18/2016
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