340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HY-VEE PHARMACY #1056
DSH160045 ST LUKES METHODIST HOSPITAL
Print
Covered Entity Details
Entity Name
ST LUKES METHODIST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH160045
Entity Address
1026 A AVENUE NE
CEDAR RAPIDS, IA 52402-3026
Medicare Provider Number
160045
Participating Start Date
1/1/2014
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
HY-VEE PHARMACY #1056
Pharmacy Address
20 WILSON AVENUE SW
CEDAR RAPIDS, IA 52404
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lucas Hicks, VP - Finance
(319) 369-8114
Contract Pharmacy Representative
Hy-Vee, Inc
Ashley Plum, 340B Coordinator
(515) 559-5708
Signed By Date
1/15/2025
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