340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MERCYONE GENESIS FIRSTMED SPECIALTY PHAR
DSH160080 MERCY MEDICAL CENTER-CLINTON INC D/B/A MercyOne Clinton Medical Center
Print
Covered Entity Details
Entity Name
MERCY MEDICAL CENTER-CLINTON INC D/B/A MercyOne Clinton Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH160080
Entity Address
1410 N FOURTH STREET
CLINTON, IA 52732
Medicare Provider Number
160080
Participating Start Date
4/1/2020
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
MERCYONE GENESIS FIRSTMED SPECIALTY PHAR
Pharmacy Address
GENVENTURES INC
1227 E RUSHOLME ST
DAVENPORT, IA 52803
Pharmacy Comments
Contract Details
Approval Date
11/7/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mellissa Wood, COO/CNE
(563) 244-5608
Contract Pharmacy Representative
MercyOneGenesis Health System
Jason Hansel, Director, OP Pharmacy
(563) 421-2593
Signed By Date
11/7/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session