340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
IOWA CVS PHARMACY, L.L.C.
SCH160064-00 MERCYONE NORTH IOWA MEDICAL CENTER
Print
Covered Entity Details
Entity Name
MERCYONE NORTH IOWA MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH160064-00
Entity Address
1000 4TH STREET SW
MASON CITY, IA 50401
Medicare Provider Number
160064
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
IOWA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08544
1825 E SAN MARNAN DRIVE
WATERLOO, IA 50702
Pharmacy Comments
Contract Details
Approval Date
3/7/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Trammel, HM VP Finance
(641) 428-7984
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2025
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