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AMBER ENTERPRISES, INC
DSH160058 UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER
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Covered Entity Details
Entity Name
UNIVERSITY OF IOWA HEALTH CARE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH160058
Entity Address
200 HAWKINS DRIVE
IOWA CITY, IA 52242
Medicare Provider Number
160058
Participating Start Date
10/1/1999
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
AMBER ENTERPRISES, INC
Pharmacy Address
DBA AMBER SPECIALTY PHARMACY
10004 S 152ND ST STE A
OMAHA, NE 68138-3931
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Saradeep Singh, COO
(319) 353-7202
Contract Pharmacy Representative
Micaila Ruiz, Chief Pharmacy Officer
(888) 370-1724
Signed By Date
7/17/2017
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